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At least 19 recordsLinked to original sources
PubMed2003

Doppler-guided cannulation of internal jugular vein, subclavian vein and innominate (brachiocephalic) vein--a case-control comparison in patients with reduced and normal intracranial compliance.

OBJECTIVE: A case-control comparison of Doppler guidance on the success rate of central venous cannulation in patients with normal or reduced intracranial compliance. DESIGN: A single operator performed central venous access procedures with continuous wave Doppler guidance. It was used on patients on a ventilator. The position of patients with reduced intracranial compliance (RIC) was not changed for the procedure. Patients with normal intracranial compliance (NIC) were put in the Trendelenburg position. SETTING: We prospectively evaluated 249 Doppler-guided central venous access procedures performed over a 12-month period at our 10-bed neuro-intensive care unit at a university hospital. PATIENTS AND PARTICIPANTS: The group with RIC included 26 males and 35 females (n=61) aged 16-79 years. In this group 155 Doppler-guided cannulation procedures (62%) were performed. The group with NIC (n=52) comprised 29 males and 23 females aged 34-76 years; 94 Doppler-guided cannulation procedures (38%) were carried out. MEASUREMENTS AND RESULTS: The veins cannulated in RIC and NIC, respectively, were: right innominate vein: 24/18, left innominate vein 26/12, right subclavian vein 12/7, left subclavian vein 25/14, and right internal jugular vein 33/18 and left internal jugular vein 35/24. The absence of one left internal jugular vein was identified in the NIC group. The success rate of first needle pass in patients with RIC was 92% and in patients with NIC 89%. CONCLUSIONS: This study showed that Doppler guidance allows the cannulation of central veins in patients with RIC placed in head-up position. Cannulation can be ensured and first-pass needle placement maximised.

Adolescent↗
PubMed1996

Abdominal CT findings when the superior vena cava, brachiocephalic vein, or subclavian vein is obstructed.

OBJECTIVE: We evaluated findings on contrast-enhanced abdominal CT scans that suggest obstruction of the superior vena cava, brachiocephalic vein, or subclavian vein. SUBJECTS AND METHODS: We conducted a retrospective review of 22 patients with superior vena caval, brachiocephalic vein, or subclavian vein obstruction and analyzed the upper abdominal images on a chest CT scan or an abdominal CT scan. We assessed collateral vessels in the upper abdomen to answer the following question: Did enhancement approach undiluted IV contrast or were there other findings? In the second part of our study, we conducted a prospective review of abdominal CT scans of 200 patients without known mediastinal disease or known upper extremity venous occlusion to determine the frequency of abnormal enhancement of these vessels in a healthy population. RESULTS: The groups of collateral vessels revealed on abdominal CT scans were azygos or hemiazygos veins, internal mammary veins, lateral thoracic and superficial thoracoabdominal veins, vertebral venous plexus veins, and small mediastinal collateral veins. In the retrospective series, one patient had focal enhancement of the liver and early inferior vena caval enhancement due to collateral vessels. In the prospective series, abdominal CT scans of two patients (1%) revealed dense undiluted enhancement of one or more groups of collateral vessels: One patient had an ipsilateral pacemaker, and the other patient had an anterior neck phlegmon to the upper mediastinum. Both conditions may have been factors in the revealing of the collateral vessels. Two other patients (1%) in the prospective series had mild to moderate vessel enhancement that was less than that from undiluted contrast material. In one of these patients, the enhancement was related to abdominal wall hyperemia after surgery. In the other patient, enhancement may have been the result of ipsilateral axillary nodes. CONCLUSION: On upper abdominal CT scans, dense undiluted contrast material in the collateral vessel groups that we studied suggests possible obstruction of the superior vena cava, brachiocephalic vein, or subclavian vein.

Abdomen↗
PubMed1996

[Transposition of the external jugular vein onto the subclavian vein in the treatment of symptomatic stenosis of the right subclavian vein].

Subclavian vein stenosis is a classical complication of longterm venous catheterization in hemodialysis. We report the case of a 74 years-old woman, operated for multiple arteriovenous fistulae, admitted to hospital with upper-limb oedema. Venous angiography demonstrated subclavian stenosis. Surgical treatment was performed by transposition of the external jugular vein onto the subclavian vein with a good result.

Aged↗
PubMed1991

Subclavian vein stenosis: complication of subclavian vein catheterization for hemodialysis.

Subclavian vein catheterization is a relatively safe procedure. Few long-term complications have been reported. We recently diagnosed subclavian vein stenosis in a 14-year-old peritoneal dialysis patient. The stenosis occurred 2 years after the use of a subclavian vein catheter for temporary hemodialysis. Stenosis became clinically apparent by progressive painless swelling of the right arm and was documented by venography.

Adolescent↗
PubMed1986

Subclavian vein thrombosis: a frequent complication of subclavian vein cannulation for hemodialysis.

Subclavian vein cannulation was suggested as a temporary vascular access for hemodialysis since one of its advantages was considered to be no damage to blood vessels. As we observed six patients with symptomatic subclavian vein thrombosis among 148 patients having received subclavian vein cannulation for hemodialysis, we systematically performed subclavian venogram in 42 asymptomatic patients selected on the basis of a history of previous subclavian vein cannulation. Venograms were performed 15.7 +/- 8.9 months after the removal of the last catheter. Eight patients (19%) had complete thrombosis or severe stenosis of the subclavian vein while six patients (14%) had minimal luminal defects. Considering together the 48 patients, the group with thrombosis or severe stenosis (group 1, n = 14) was compared with the group with minimal defects or normal venograms (group 2, n = 34). In group 1, as compared with group 2, there were more female (64% vs 32%, p = 0.02), more cannulations per vein (1.87 +/- 0.35 vs 1.32 +/- 0.08, p less than 0.05) and more cumulative days of cannulation per vein (35.1 +/- 7.9 vs 24.4 +/- 1.1, p less than 0.001). No difference between the two groups was seen for the number of catheter infections, the number of catheters with poor flow or obstruction, the coagulation screening of the patients or the time-length between the removal of the last catheter and the venogram study. Two of the initially asymptomatic patients developed later on clinical problems related to the subclavian vein thrombosis. We conclude that the subclavian vein cannulation leads to significant damages of the vessels, excluding a whole arm, for future vascular access in some patients.

Catheterization↗
PubMed1995

Surgical management of subclavian vein obstruction, including six cases of subclavian vein bypass.

BACKGROUND: The indications are still being developed for the various procedures available to treat thrombotic and nonthrombotic subclavian vein obstruction. This article explores our experience with the surgical options, primarily with chronic venous occlusion, but also with acute thrombosis. METHODS: Twelve patients presented with acute or chronic venous thrombosis or nonthrombotic venous obstruction. Treatment included thrombolysis, vein patch angioplasty, thrombectomy, first rib resection, venolysis, and/or subclavian vein bypass by either jugular vein transposition or prosthetic axillojugular bypass. RESULTS: Six patients experienced relief of all symptoms; the other six have had relief from pain but continue to have occasional swelling. CONCLUSIONS: On the basis of our anecdotal experiences and those of others, the following protocol has been developed. After acute thrombosis, lytic therapy is recommended. If successful, first rib resection and venolysis should be considered; if unsuccessful and the patient has significant symptoms, immediate thrombectomy is indicated. If patency is established, rib resection and venolysis should follow. Persistent stenosis is treated by angioplasty, either with a vein patch or percutaneously. Complete occlusion is managed by jugular vein transposition or axillojugular bypass. Temporary arteriovenous fistulas accompany all open venous repairs.

Adolescent↗
PubMed1994

Internal jugular to axillary vein bypass for subclavian vein thrombosis in the setting of brachial arteriovenous fistula.

Placement of central venous catheter is the most common cause of subclavian vein thrombosis. In the setting of a functioning ipsilateral brachial arteriovenous fistula, venous hypertension symptoms may be exacerbated. We report successful decompression of severe venous hypertension in the right arm of a patient whose only access for hemodialysis was a functioning right brachial arteriovenous fistula and in whom proximal subclavian vein occlusion developed from a previous percutaneous dialysis catheter. Transposition of the right internal jugular vein and end-to-side anastomosis to the right axillary vein provided prompt and effective venous outflow, with complete resolution of venous engorgement of the affected limb and preservation of the dialysis fistula.

Arteriovenous Shunt, Surgical↗
PubMed1990

[Late pneumothorax: a complication of subclavian vein catheterization].

Subclavian vein catheterization is safe as long as proper indications and contraindications are observed. In the hands of highly qualified personnel, subclavian vein catheterization has a minimum rate of complications. Pneumothorax is by far the most common complication of the procedure. We describe a 64-year-old man who developed pneumothorax late after left subclavian vein catheterization.

Catheterization, Central Venous↗
PubMed1993

[A case of invasive thymoma requiring the resection and vascular reconstruction of the left brachiocephalic and subclavian vein].

The patient was a 58 years old female with invasive thymoma, which invaded the left brachiocephalic vein, left subclavian vein, pericardium and left lung. These invaded organs were resected with the tumor, and a vascular reconstruction was performed between the left axillary vein and the superior vena cava by means of an expanded polytetrafluoroethylene graft. In order to expose the entire length of the left brachiocephalic vein and left subclavian vein, anterolateral thoracotomy at the first intercostal space and resection of the first rib was performed in addition to the median sternotomy. This method can be used in the resection and reconstruction of a subclavian vein invaded by an anterior mediastinal tumor.

Blood Vessel Prosthesis↗