Clinical radiology
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Central venous catheters provide an important means of long-term vascular access in a variety of clinical situations. Catheter placement and evaluation is now forming an increasing part of the workload of interventional radiologists. ⋯ We outline the causes of catheter related problems and discuss the treatment options. We include examples of catheter malfunction resulting from malposition, displacement, kinking and occlusion.
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Peripherally inserted central catheters (PICCs) are an increasingly used means of medium to long-term intravenous access. We have established an ultrasound (US) guided PICC insertion service at our institution that has largely replaced blind bedside insertions. One hundred and six PICCs were inserted in the upper arms of 89 patients, over a 6-month period with a 100% success rate. ⋯ Catheter blockage, breakage and partial unintentional removal are potentially remediable complications using guide-wire techniques under fluoroscopic guidance. The management of catheter related infection is discussed. We have encouraged early communication with our clinical colleagues in order to facilitate the management of such complications and minimize unnecessary catheter removal.