The journal of vascular access
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Randomized Controlled Trial Comparative Study
Ultrasound-guided proximal versus distal axillary vein puncture in elderly patients: A randomized controlled trial.
Ultrasound-guided axillary vein catheterization is now widely used in hospital, but it remains uncertain whether the distal axillary vein approach is more beneficial for seniors than the proximal axillary vein approach. This study aims to compare the puncture success rate and anatomical characteristics between these two approaches. ⋯ For catheterization under ultrasound guidance in elderly patients, the proximal axillary vein approach is superior to the distal axillary vein approach.
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Vascular access for central venous catheter placement is technically challenging in children. Ultrasound guidance is recommended for pediatric central venous catheter placement, yet many practitioners rely on imprecise anatomic landmark techniques risking procedure failure due to difficulty mastering ultrasound guidance. A novel navigation system provides a visual overlay on real-time ultrasound images to depict needle trajectory and tip location during cannulation. We report the first pediatric study assessing feasibility and preliminary safety of using a computer-assisted needle navigation system to aid in central venous access. ⋯ This pilot study suggests that it is feasible to use a novel computer-assisted needle navigation system to safely obtain central venous access under ultrasound guidance in pediatric patients.
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Totally implantable venous access ports are widely used in chemotherapy for malignant tumors. This retrospective study investigated the safety, technical feasibility, and device-related complications of totally implantable venous access ports implanted in the upper arm. ⋯ Implanting totally implantable venous access ports in the upper arm is feasible and safe for patients with early breast cancer, with a low rate of complications, providing good alternative to central venous ports.
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Vascular access in oncology patients can often be challenging, especially after a few cycles of chemotherapy through peripheral lines which can cause veins to become attenuated. We evaluated the feasibility of centrally placed non-cuffed tunnelled peripherally inserted central catheter in the chest as an alternative to conventional peripherally inserted central catheter. ⋯ Centrally placed tunnelled peripherally inserted central catheter is a promising alternative method, when conventional arm peripherally inserted central catheter placement is not feasible. It is an easy and safe procedure that can be performed under local anaesthesia.
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Comparative Study Observational Study
Ultrasound-guided tip location of midline catheters.
Midline catheters are widely used in clinical practice. Proper placement of midline catheter tip is usually assessed only by aspirating blood and flushing with normal saline without resistance. ⋯ The ideal position of the tip of a midline catheter might be inside the axillary vein, about 3 cm distal to the axillary-subclavian transition or inside the subclavian vein. Ultrasound-guided tip location is safe, inexpensive, easy and potentially useful during midline catheters insertion.