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1.
Medicine (Baltimore) ; 101(43): e31249, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316874

RESUMO

OBJECTIVE: We hypothesized that when a right-handed operator catheterizes the left internal jugular vein (IJV), the tip of the needle might be positioned closer to the center of the vessel after puncture if the operator is standing in the patient's left axillary line, rather than standing cephalad to the patient. METHODS: The study randomly allocated 44 patients undergoing elective surgery under general anesthesia with planned left central venous catheterization to either conventional (operator stood cephalad to the patient) or intervention (operator stood in the patient's axillary line) groups. The left IJV was catheterized by 18 anesthesiologists. The distance between the center of the vessel and the needle tip, first-attempt success rate, and procedure time were compared. RESULTS: The distance from the needle tip to the center of the IJV after needle puncture was 3.5 (1.9-5.5) and 3.2 (1.7-4.9) cm in the conventional and intervention groups, respectively (P = .47). The first-attempt success rate was significantly higher in the intervention group (100% vs 68.2%, P = .01). Overall time to successful guidewire insertion was faster in the intervention group (P = .007). CONCLUSIONS: There was no significant difference in needle tip position when the right-handed operator was standing in the patient's left axillary line compared to standing cephalad to the patient during left IJV catheterization. However, it increased the first-attempt success rate and reduced the overall time for guidewire insertion.


Assuntos
Cateterismo Venoso Central , Humanos , Cateterismo Venoso Central/métodos , Veias Jugulares/diagnóstico por imagem , Veias Braquiocefálicas/diagnóstico por imagem , Agulhas , Ultrassonografia de Intervenção/métodos
2.
Medicine (Baltimore) ; 101(43): e31207, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316929

RESUMO

BACKGROUND: This study aimed to detect the correlation of central venous pressure (CVP) with the internal jugular vein (IJV), common carotid artery (CCA), femoral vein (FV), and femoral artery (FA) diameters measured with ultrasound (USG) in patients under mechanical ventilation to evaluate whether they are suitable to be used as an alternative low-cost and noninvasive method for the detection of CVP. METHODS: A total of 40 patients aged from 18 to 90 who had been receiving therapy in the intensive care unit (ICU) were included in the study. Central venous catheter was placed into the patients through right IJV or subclavian vein in their first 24-hour of hospitalization and the right atrium pressure (RAP) was measured from the catheter, the tip of which was confirmed to reach right atrium. In the same session, CCA, IJV, FA, and FV diameters were measured with USG and their correlations with CVP were calculated. In addition, correlations of the measured venous and artery diameters between each other were detected as well. RESULTS: There was a significantly high correlation between CVP and CCA diameter (R = 0.603, P < .000). There was a significantly low correlation between CVP and IJV diameter (R = 0.352, P = .026), a significantly low correlation between FA and FV diameters (R = 0.317, P = .047), a significantly low correlation between FA and CCA diameters (R = 0.330, P = .038), and a significantly low correlation between IJV and CCA diameters (R = 0.364, P = .020). CONCLUSION: CVP and CCA diameters exhibited a high correlation. For detection of CVP, the ultrasonographic CCA diameter measurement can be used as an alternative noninvasive method which is easy to use and minimally affected by measurement errors of individuals and which has low learning curve compared with the other measurement methods.


Assuntos
Cateterismo Venoso Central , Veias Jugulares , Humanos , Veias Jugulares/diagnóstico por imagem , Pressão Venosa Central , Veia Femoral/diagnóstico por imagem , Artéria Femoral/diagnóstico por imagem , Artéria Carótida Primitiva/diagnóstico por imagem , Ultrassonografia , Cateterismo Venoso Central/métodos
3.
Heart Surg Forum ; 25(5): E750-E752, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36317901

RESUMO

Internal jugular vein placement is frequently utilized in clinical practice for rapid infusion, intraoperative monitoring, peritoneal dialysis, and access for interventions. Additionally, the process may lead to complications like hematoma, infection, misdirection of the artery, pneumothorax, and arteriovenous fistula. In the case described in this report, all vascular ruptures effectively were repaired because when internal jugular vein placement was adopted, a dialysis catheter would go through the right internal jugular vein into the subclavian artery, then the ascending aorta via the cephalic trunk, and finally the ectopic catheter would be surgically removed. The patient was released from the hospital on the seventh postoperative day after maintaining stable vital signs throughout the procedure.


Assuntos
Fístula Arteriovenosa , Cateterismo Venoso Central , Humanos , Veias Jugulares/cirurgia , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/métodos , Fístula Arteriovenosa/etiologia , Veias Braquiocefálicas , Aorta
5.
J Biomed Opt ; 27(11)2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36385200

RESUMO

SignificanceThe internal jugular veins (IJV) are critical cerebral venous drainage pathways that are affected by right heart function. Cardiovascular disease and microgravity can alter central venous pressure (CVP) and venous return, which may contribute to increased intracranial pressure and decreased cardiac output. Assessing jugular venous compliance may provide insight into cerebral drainage and right heart function, but monitoring changes in vessel volume is challenging.AimWe investigated the feasibility of quantifying jugular venous compliance from jugular venous attenuation (JVA), a noncontact optical measurement of blood volume, along with CVP from antecubital vein cannulation.ApproachCVP was progressively increased through a guided graded Valsalva maneuver, increasing mouth pressure by 2 mmHg every 2 s until a maximum expiratory pressure of 20 mmHg. JVA was extracted from a 1-cm segment between the clavicle and midneck. The contralateral IJV cross-sectional area (CSA) was measured with ultrasound to validate changes in the vessel size. Compliance was calculated using both JVA and CSA between four-beat averages over the duration of the maneuver.ResultsJVA and CSA were strongly correlated (median and interquartile range) over the Valsalva maneuver across participants (r = 0.986, [0.983, 0.987]). CVP more than doubled on average between baseline and peak strain (10.7 ± 4.4 vs. 25.8 ± 5.4 cmH2O; p < 0.01). JVA and CSA increased nonlinearly with CVP, and both JVA- and CSA-derived compliance decreased progressively from baseline to peak strain (49% and 56% median reduction, respectively), with no significant difference in compliance reduction between the two measures (Z = - 1.24, p = 0.21). Pressure-volume curves showed a logarithmic relationship in both CSA and JVA.ConclusionsOptical jugular vein assessment may provide new ways to assess jugular distention and cardiac function.


Assuntos
Veias Jugulares , Manobra de Valsalva , Humanos , Veias Jugulares/diagnóstico por imagem , Pressão Venosa Central , Ultrassonografia/métodos
6.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 53(5): 821-827, 2022 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-36224684

RESUMO

Objective: To compare and investigate the differences and characteristics of pulmonary vascular remodeling in three mouse models of pulmonary arterial hypertension (PAH) constructed by left pneumonectomy, jugular vein injection of monocrotaline pyrrole, and left pneumonectomy combined with jugular vein injection of monocrotaline pyrrole, to explore for a PAH animal model that approximates the clinical pathogenesis of PAH, and to create a model that will provide sound basis for thorough investigation into the pathogenesis of severe PAH. Methods: 59 male C57/BL mice (10-12 weeks, 24-30 g) were randomized into four groups, a control group ( n=9), a group that had left pneumonectomy (PE, n=15), a group that had jugular vein injection of monocrotaline pyrrole (MCTP, n=15), and the last group that had left pneumonectomy combined with jugular injection of monocrotaline pyrrole (P+M, n=20). To evaluate the effect of modeling and the characteristics of pulmonary vascular remodeling, hemodynamic and morphological parameters, including right ventricular systolic pressure (RVSP), right ventricle/(left ventricle plus septum) (RV/LV+S), percent of wall thickness in the pulmonary artery (WT%), muscularization of non-muscular arteries, neointima formation, and vascular obstruction score (VOS), were measured in each group. Results: 1) Compared with those of the control group, the RVSP, RV/LV+S, WT%, and the degree of small pulmonary arteries muscularization in the P+M group were significantly increased ( P<0.01). The MCTP group had just slightly higher findings for these indicators ( P<0.05), while no significant change in these indicators was observed in the PE group ( P>0.05). 2) Neointima formation in the acinus pulmonary arteries, which caused obvious stenosis of the lumen, was observed in the P+M group, the VOS being 1.25±0.80 points ( P<0.001). In contrast, neointima formation was not observed in the MCTP group or the PE groups, the VOS being 0 point ( P>0.05). Conclusion: Left pneumonectomy combined with jugular intravenous injection of MCTP could induce severe PAH formation in mouse. The model provides a good simulation of neointima formation, the characteristic pathological change of clinical severe PAH.


Assuntos
Hipertensão Pulmonar , Hipertensão Arterial Pulmonar , Animais , Modelos Animais de Doenças , Hipertensão Pulmonar/induzido quimicamente , Hipertensão Pulmonar/tratamento farmacológico , Veias Jugulares , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Monocrotalina/análogos & derivados , Neointima/patologia , Pneumonectomia , Hipertensão Arterial Pulmonar/induzido quimicamente , Artéria Pulmonar , Remodelação Vascular
7.
J Vis Exp ; (187)2022 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-36190275

RESUMO

Dynamic analysis of blood components is of great importance in understanding cardiovascular diseases and their related diseases, such as myocardial infarction, arrhythmia, atherosclerosis, cardiogenic pulmonary edema, pulmonary embolism, and cerebral embolism. At the same time, it is urgent to break through the continuous heart blood sampling technique in live rats to evaluate the effectiveness of distinctive ethnic medicine therapy. In this study, a blood microdialysis probe was implanted in the right jugular vein of rats in a precise and noninvasive surgical procedure. Cardiac blood samples were then collected at a rate of 2.87 nL/min to 2.98 mL/min by connecting to an online microdialysis sample collection system. Even more momentously, the acquired blood samples can temporarily be stored in microdialysis containers at 4 °C. The microdialysis-based online continuous blood collection program from rat heart has greatly guaranteed the quality of blood samples, advancing and invigorating the scientific rationality of the research on systemic cardiovascular diseases and evaluating ethnomedicine therapy from the perspective of hematology.


Assuntos
Doenças Cardiovasculares , Animais , Veias Jugulares , Microdiálise/métodos , Monitorização Fisiológica , Ratos , Ratos Sprague-Dawley
8.
J Coll Physicians Surg Pak ; 32(10): 1249-1254, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36205266

RESUMO

OBJECTIVE: To determine the effect of single-shot interscalene brachial plexus (ISBP) block on intracranial pressure (ICP) by evaluating the extravascular volume effect of the medicine on the internal jugular vein (IJV). STUDY DESIGN: Interventional study. PLACE AND DURATION OF STUDY: Department of Anaesthesiology and Reanimation, Sivas Cumhuriyet University, Sivas, Turkey, from January to June 2022. METHODOLOGY: Thirty-four patients were included in this prospective clinical study. All patients had single-shot ISBP block with 25 ml of local anaesthetic. Optic nerve sheath diameter (ONSD), maximum (Dmax) and minimum (Dmin) diameters of IJV and IJV collapsibility index (IJV-CI) were recorded before the block (basal), 20 minutes, and 60 minutes after the block. RESULTS: Twenty-nine patients had higher ONSD values at 60th minute compared to their basal values. There were negative correlations between the changes of ONSD and IJVCI (r=0.616, p<0.001) and ONSD and Dmax (r=0.581, p<0.001) in time period between basal and 20th minute. There were negative correlations between the changes of ONSD and IJVCI (r=0.518, p=0.002), ONSD and Dmax (r=0.664, p<0.001) in time period between basal and 60th minute. CONCLUSION: Single-shot ISBP block with 25 ml of local anaesthetic may be a factor that increases ICP. Repeated intraoperative ONSD measurements are recommended in patients operated with ISBP block. KEY WORDS: Interscalene Brachial Plexus Block, Intracranial pressure, Optic nerve sheath diameter, Internal jugular vein collapsibility index.


Assuntos
Bloqueio do Plexo Braquial , Hipertensão Intracraniana , Anestésicos Locais , Humanos , Pressão Intracraniana/fisiologia , Veias Jugulares , Nervo Óptico/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia
9.
J Stroke Cerebrovasc Dis ; 31(12): 106808, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36201990

RESUMO

The posterior condylar vein is an emissary vein that connects the extracranial and intracranial venous systems through the posterior condylar canal (PCC). Dural arteriovenous fistulas (DAVF) of the PCC are rare, and only seven cases have been reported. Transvenous embolization (TVE) is the first-line treatment for PCC DAVF and is predominantly performed through the internal jugular vein. Herein, we report a case of PCC DAVF treated with TVE through the deep cervical vein. This is the first case report of a PCC DAVF treated with TVE through the deep cervical vein.


Assuntos
Malformações Vasculares do Sistema Nervoso Central , Embolização Terapêutica , Humanos , Angiografia Cerebral , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/terapia , Veias Jugulares/diagnóstico por imagem
12.
Br J Anaesth ; 129(6): 843-850, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36280461

RESUMO

BACKGROUND: Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications. METHODS: All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion. Every insertion was monitored for complete documentation and occurrence of mechanical complications within 24 h after catheterisation. Multivariable logistic regression analyses were used to determine associations between predefined variables and mechanical complications. RESULTS: In total, 12 667 catheter insertions in 8586 patients were included. The incidence (95% confidence interval [CI]) of mechanical complications was 7.7% (7.3-8.2%), of which 0.4% (0.3-0.5%) were major complications. The multivariable analyses showed that patient BMI <20 kg m-2 (odds ratio 2.69 [95% CI: 1.17-5.62]), male operator gender (3.33 [1.60-7.38]), limited operator experience (3.11 [1.64-5.77]), and increasing number of skin punctures (2.18 [1.59-2.88]) were associated with major mechanical complication. Subclavian vein catheterisation was associated with pneumothorax (5.91 [2.13-17.26]). CONCLUSIONS: The incidence of major mechanical complications is low in hospitals where real-time ultrasound guidance is the standard of care for central venous access. Several variables independently associated with mechanical complications can be used for risk stratification before catheterisation procedures, which might further reduce complication rates. CLINICAL TRIAL REGISTRATION: NCT03782324.


Assuntos
Cateterismo Venoso Central , Humanos , Masculino , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/métodos , Veias Jugulares/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia de Intervenção/métodos , Ultrassonografia
13.
World J Gastroenterol ; 28(31): 4467-4470, 2022 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-36159008

RESUMO

This letter is regarding the study titled 'Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt (TIPS) to reduce hepatic encephalopathy'. Prior to the approval of TIPS dedicated stents (Viatorr stents) in China in October 2015, Fluency covered stents were typically used. As Fluency covered stents have a strong support force and axial elastic tension, a 'cap' may form if the stent is located too low at the end of the hepatic vein or too short at the end of the portal vein during surgery, leading to stent dysfunction. Since the blood shunted by the stent is from the main trunk of the portal vein, the correlation between the incidence of postoperative hepatic encephalopathy and the location of the puncture target (left or right portal vein branch) is worth discussion. Notably, no studies in China or foreign countries have proven the occurrence of left and right blood stratification after the accumulation of splenic vein and mesenteric blood flow in the main trunk of the portal vein in patients with cirrhotic portal hypertension.


Assuntos
Encefalopatia Hepática , Hipertensão Portal , Derivação Portossistêmica Transjugular Intra-Hepática , Humanos , Hipertensão Portal/etiologia , Hipertensão Portal/cirurgia , Veias Jugulares/cirurgia , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Estudos Retrospectivos , Stents/efeitos adversos , Resultado do Tratamento
14.
Am J Emerg Med ; 61: 98-104, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36058204

RESUMO

INTRODUCTION: Lemierre's syndrome is a serious condition that carries with it a high rate of morbidity and even mortality. OBJECTIVE: This review highlights the pearls and pitfalls of Lemierre's syndrome, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence. DISCUSSION: Lemierre's syndrome is a condition marked by septic thrombophlebitis of the internal jugular vein (IJV), with the classic triad of pharyngotonsillitis, IJV thrombosis, and septic emboli resulting in metastatic abscess. It typically begins as pharyngitis, often caused by Fusobacterium necrophorum. Patients most commonly present with fever, recently diagnosed pharyngitis, and neck pain or swelling. Septic emboli may affect multiple organ systems, most commonly the pulmonary system. The disease should be considered in patients with prolonged symptoms of pharyngitis, pharyngitis that improves but then worsens, critically ill patients with pharyngitis, patients with pharyngitis and infection at a secondary site, and neck signs/symptoms. Diagnosis includes throat and blood cultures, as well as imaging to include computed tomography of the neck and chest with intravenous contrast. Additional imaging of other areas should be performed as clinically indicated. Initial management includes hemodynamic stabilization with intravenous fluids and vasopressors as needed, as well as broad-spectrum antibiotics. Anticoagulation for the primary thrombus and possible septic emboli is controversial and should be considered in a multidisciplinary approach with admission. CONCLUSIONS: An understanding of Lemierre's syndrome can assist emergency clinicians in diagnosing and managing this potentially deadly disease.


Assuntos
Síndrome de Lemierre , Faringite , Sepse , Humanos , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/epidemiologia , Síndrome de Lemierre/complicações , Prevalência , Faringite/diagnóstico , Veias Jugulares/diagnóstico por imagem , Sepse/complicações , Antibacterianos/uso terapêutico , Anticoagulantes
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 4022-4025, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36086322

RESUMO

Jugular venous pulse (JVP) helps in the early detection of central venous pressure abnormalities and various cardiovascular diseases. Studies have been reported indicating that contour features of the JVP waveform provide crucial information regarding cardiac function. Although current ultrasound systems reliably provide the diameter measurements, they are limited by low frame rates resulting in poor resolution JVP cycles that are inadequate to yield distinguishable critical points. In this work, we propose an image-free high frame rate system for the assessment of JVP signals. The proposed A-mode ultrasound system acquires high fidelity JVP pulses with a temporal resolution of 4 ms and amplitude resolution of 10 µm. The functionality verification of the proposed system was performed by comparing it against a clinical-grade B-mode imaging system. A study was conducted on a cohort of 25 subjects in the 20-30 age group. While the system provided diameter measurements comparable to that of the imaging ones (r > 0.98, p < 0.05), it also yielded high-resolution JVP exhibiting the presence of all fiduciary points. This was a leveraging feature as opposed to the imaging system that possessed limited temporal and amplitude resolution. Clinical Relevance- The proposed system is a potential ultrasound means for measuring the diameter values from JV at the same time yielding the JVP critical points necessary for clinical analysis.


Assuntos
Veias Jugulares , Pressão Venosa Central , Estudos de Viabilidade , Frequência Cardíaca , Humanos , Veias Jugulares/diagnóstico por imagem , Ultrassonografia/métodos
16.
PLoS One ; 17(9): e0275453, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36178956

RESUMO

The ultrasound-guided long-axis in-plane approach for central venous catheterization in infants and small children can prevent posterior wall penetration. The combined short-axis out-of-plane and long-axis in-plane approach reportedly prevents such penetration in adults. To test the hypothesis of non-inferiority of the combined approach to the long-axis in-plane approach, we compared the two approaches in infants and small children. Patients were randomized based on whether they underwent ultrasound-guided internal jugular vein catheterization using the combined or long-axis in-plane approach. Posterior wall penetration rates, first-attempt success rates, overall success rates within 20 min; scanning, puncture, and procedure durations; and number of attempts were compared between the groups. In the combined and long-axis in-plane groups (n = 55 per group), the posterior wall penetration rates were 5.5% (3/55) and 3.6% (2/55) (P = 0.65), the first-attempt success rates were 94.5% (52/55) and 92.7% (51/55) (P = 0.70), and the overall success rates within 20 min were 100% (55/55) and 98.2% (54/55) (P = 0.32), respectively. In the combined and long-axis in-plane groups, the median (interquartile range) scanning durations were 21 (16.5-34.8) s and 47 (29.3-65) s (P<0.0001), the puncture durations were 114 (83-170) s and 74 (52.3-117.3) s (P = 0.0002), and the procedure durations were 141 (99-97.8) s and 118 (88.5-195.5) s (P = 0.14), respectively. The median number of attempts was 1 (interquartile range: 1-1, range: 1-3) in both groups (P = 0.72). Similar to the long-axis in-plane approach, the combined approach for internal jugular vein catheterization prevented posterior wall penetration in infants and small children. Trial registration: This trial was registered before patient enrollment in the University Hospital Medical Information Network Clinical Trials Registry, registration number UMIN000039387 (https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000044907).


Assuntos
Cateterismo Venoso Central , Adulto , Cateterismo Venoso Central/métodos , Criança , Humanos , Lactente , Veias Jugulares/diagnóstico por imagem , Punções/métodos , Ultrassonografia , Ultrassonografia de Intervenção/métodos
18.
Thromb Res ; 218: 192-198, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36087355

RESUMO

INTRODUCTION: Lack of standardized definition impedes our ability to understand the clinical significance of asymptomatic central venous catheter (CVC) associated deep venous thrombosis (CADVT). Using standardized definitions, we aimed to determine the accuracy of physical examination in detecting CADVT in critically ill children and to identify characteristics associated with this accuracy. MATERIALS AND METHODS: In a post hoc study, we analyzed 236 children <18 years old admitted to the pediatric intensive care unit, had an untunneled CVC and surveilled for CADVT using ultrasound with paired physical examination. RESULTS: Of 236 paired examinations, 79 (33.5 %) had CADVT on ultrasound, while 56 (23.7 %) had signs of inflammation or venous obstruction on physical examination or CVC dysfunction. Sensitivity was 29.2 % (95 % confidence interval, CI: 19.9 %, 38.5 %), specificity was 80.2 % (95 % CI: 73.9 %, 86.4 %) and area under the receiver operating characteristic curve (AUROC) was 0.55 (95 % CI: 0.49, 0.60). When CVC dysfunction was excluded, sensitivity was lower (11.1 %; 95 % CI: 4.6 %, 17.6 %; p = 0.002), but specificity was higher (88.7 %; 95 % CI: 83.6 %, 93.7 %, p = 0.04). AUROC was 0.50 (95 % CI: 0.46, 0.54; p = 0.17). Use of point-of-care ultrasound and CVC inserted in the internal jugular vein (vs femoral vein) had lower sensitivity. Sepsis or infection and vasoactive support had lower specificity. Center of enrollment was associated with variable sensitivity. CONCLUSIONS: Physical examination has poor accuracy in detecting CADVT in critically ill children. Despite poor accuracy, physical examination that includes assessment of CVC dysfunction, in combination with imaging, is key to understanding the clinical significance of asymptomatic CADVT.


Assuntos
Cateteres Venosos Centrais , Trombose Venosa Profunda de Membros Superiores , Adolescente , Cateteres Venosos Centrais/efeitos adversos , Criança , Estado Terminal , Humanos , Veias Jugulares , Exame Físico
20.
Gan To Kagaku Ryoho ; 49(8): 887-889, 2022 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-36046976

RESUMO

Subcutaneous implantable venous ports were placed in 414 patients between April 2016 and August 2021 for the purpose of breast cancer chemotherapy in our hospital. Although the internal jugular vein approach was selected to prevent fractures caused by pinch-off syndrome, catheter fracture occurred in 8 patients(1.9%). All patients were ADL-independent women aged 44-62 years(median, 50.5 years). The intravenous ports were placed on the side of the dominant and non-dominant hands in 4 and 4 patients, respectively. Six patients received perioperative chemotherapy, while 2 had advanced breast cancer. Catheter fractures occurred 17.7-54.2 months(median, 41.7 months)after placement. The fractures were discovered when the patients presented with one or more of the following conditions: poor backflow of blood (n=4), subcutaneous emphysema observed on CT(n=1), subcutaneous leakage of CT contrast media(n=3), and no sign or symptom(n=1). The fractures occurred in the clavicular subcutaneous part in all patients. Partial and complete fractures of the catheter occurred in 5 and 3 patients, respectively. In 3 patients with complete fracture of the catheter, catheter tips had strayed into the right atrium and were removed using percutaneous endovascular procedures.


Assuntos
Neoplasias da Mama , Cateterismo Venoso Central , Cateteres Venosos Centrais , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/etiologia , Neoplasias da Mama/cirurgia , Cateterismo Venoso Central/efeitos adversos , Cateteres de Demora/efeitos adversos , Cateteres Venosos Centrais/efeitos adversos , Feminino , Átrios do Coração , Humanos , Veias Jugulares
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