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• W2080192592 abstract "1) To identify the various patient groups who require long-term central venous access, 2) to understand the various measures that can be used to reduce the risk of venous occlusion in these patients, 3) to describe the various techniques used to obtain long-term venous access in patients with chronic venous occlusion, 4) to discuss the requirements, advantages and disadvantages of the various techniques in relation to the current literature. Tunnelled and peripherally inserted central venous catheters are used in a variety of patients requiring long-term central venous access. They are used for many reasons including dialysis, antibiotic therapy, chemotherapeutic infusion, and total parenteral nutrition. This patient population includes those who require access to be maintained for months or years. The longer a catheter is left in situ and the larger the catheter, the greater the incidence of venous occlusion. Strategies are needed to reduce the risk of this occurring and to obtain venous access should it occur. Ideally long-term venous access should be avoided if an alternative is available. If a central venous catheter is required a number of factors influence venous occlusion. These include method of insertion, catheter type and size, as well as subsequent management in the inpatient or outpatient environment. Dialysis patients are a population who can end up requiring multiple central venous catheters inserted initially via the internal jugular vein. Various alternative methods and routes exist often with limited literature available to support their use. These include translumbar and transhepatic access, recannulation of occluded thoracic veins, inserting lines into the azygous vein, CT or ultrasound-guided cannulation of collateral veins, and the dual-guidewire technique for PICC insertion via tortuous collaterals. Knowledge of the different therapeutic and management strategies to avoid venous occlusion will reduce patient morbidity. When chronic venous occlusion does occur, an understanding of the alternative methods for long-term central venous access empowers the treating physician to choose the best option for the specific patient, improving outcome." @default.
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• W2080192592 date "2011-03-01" @default.
• W2080192592 modified "2023-09-27" @default.
• W2080192592 title "Abstract No. 384: Central venous access in patients with chronic venous occlusion" @default.
• W2080192592 doi "https://doi.org/10.1016/j.jvir.2011.01.421" @default.
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