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Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization.

Pikwer, Andreas LU ; Acosta, Stefan LU ; Kölbel, Tilo LU and Åkeson, Jonas LU (2010) In Journal of Vascular Access 11. p.323-328
Abstract
ABSTRACT Objectives: This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization. Methods: Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively. Results: Sixteen patients aged 48 years (range 0.5-76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for... (More)
ABSTRACT Objectives: This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization. Methods: Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively. Results: Sixteen patients aged 48 years (range 0.5-76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for hemodialysis had had significantly fewer individual catheters inserted compared with 5 patients cannulated for nutritional support (mean 3.6 vs. 10.2, p<0.001) before endovascular intervention. Preoperative imaging by magnetic resonance tomography (MRT) in 8 patients, computed tomography (CT) venography in 3, conventional angiography in 6, and/or ultrasonography in 8, verified 15 brachiocephalic, 13 internal jugular, 3 superior caval, and/or 3 subclavian venous occlusions. Patients were subjected to recanalization (n=2), recanalization and percutaneous transluminal angioplasty (n=5), or stenting for vena cava superior syndrome (n=1) prior to catheter insertion. The remaining 8 patients were cannulated by avoiding the occluded route. Conclusions: Central venous occlusion occurs particularly in patients under hemodialysis and with a history of multiple central venous catheterizations with large-diameter catheters and/or long total indwelling time periods. Patients with central venous occlusion verified by CT or MRT venography and need for central venous access should be referred for endovascular intervention. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Vascular Access
volume
11
pages
323 - 328
publisher
Wichtig Publishing
external identifiers
  • wos:000290058200011
  • pmid:20954129
  • scopus:79955666955
ISSN
1129-7298
DOI
10.5301/JVA.2010.5813
language
English
LU publication?
yes
id
6f57a016-0f92-4f76-a85b-12935cb17734 (old id 1711059)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20954129?dopt=Abstract
date added to LUP
2010-11-05 15:35:24
date last changed
2018-05-29 10:20:54
@article{6f57a016-0f92-4f76-a85b-12935cb17734,
  abstract     = {ABSTRACT Objectives: This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization. Methods: Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively. Results: Sixteen patients aged 48 years (range 0.5-76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for hemodialysis had had significantly fewer individual catheters inserted compared with 5 patients cannulated for nutritional support (mean 3.6 vs. 10.2, p&lt;0.001) before endovascular intervention. Preoperative imaging by magnetic resonance tomography (MRT) in 8 patients, computed tomography (CT) venography in 3, conventional angiography in 6, and/or ultrasonography in 8, verified 15 brachiocephalic, 13 internal jugular, 3 superior caval, and/or 3 subclavian venous occlusions. Patients were subjected to recanalization (n=2), recanalization and percutaneous transluminal angioplasty (n=5), or stenting for vena cava superior syndrome (n=1) prior to catheter insertion. The remaining 8 patients were cannulated by avoiding the occluded route. Conclusions: Central venous occlusion occurs particularly in patients under hemodialysis and with a history of multiple central venous catheterizations with large-diameter catheters and/or long total indwelling time periods. Patients with central venous occlusion verified by CT or MRT venography and need for central venous access should be referred for endovascular intervention.},
  author       = {Pikwer, Andreas and Acosta, Stefan and Kölbel, Tilo and Åkeson, Jonas},
  issn         = {1129-7298},
  language     = {eng},
  pages        = {323--328},
  publisher    = {Wichtig Publishing},
  series       = {Journal of Vascular Access},
  title        = {Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization.},
  url          = {http://dx.doi.org/10.5301/JVA.2010.5813},
  volume       = {11},
  year         = {2010},
}