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Catheter access, sometimes called a CVC (central venous catheter), consists of a plastic catheter with two lumens (or occasionally two separate catheters) which is inserted into a large vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
Tunneled catheters have multiple channels called lumens which lay exposed on the surface of the skin. These lumens are the access points when the catheter is used. Tunneled catheters can be single, double, or triple lumened. Removal of a tunneled catheter is a simple procedure requiring only local anesthetic. A bandage is applied to the site to ...
In some situations, venous access is obtained by inserting catheters into the large central veins of the trunk of the body such as the internal jugular, subclavian, or femoral veins. This type of venous access is performed with central venous catheters (CVCs) , and is required in certain situations where peripheral access is inadequate.
The femoral vein is often used to place a central venous catheter, or line for venous access. Ultrasound imaging for locating the vein and catheter placement is advocated over the use of anatomical landmarks due to the possible presence of anatomical variants. [23] [24] [25] This is associated with a significant risk of infection. [25] [26]
Implanted central venous catheter Implanted port. The "nipples" which define the clinician's target area are here readily discerned. Gripper needle inserted in port. An implanted central venous catheter, also called a port a "cath" or "port-a-cath", is similar to a tunneled catheter, but is left entirely under the skin and is accessible via a ...
A dialysis catheter is a catheter used for exchanging blood to and from a hemodialysis machine and a patient. The dialysis catheter contains two lumens: venous and arterial. Although both lumens are in the vein, the "arterial" lumen, like natural arteries, carries blood away from the heart, while the "venous" lumen returns blood towards the heart.
Venous cutdown is an emergency procedure in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used for venous access in cases of trauma , and hypovolemic shock when the use of a peripheral venous catheter is either difficult or impossible.
The sapheno-femoral junction is tested by the Valsalva maneuver, with the use of color Doppler being helpful at this stage. [35] The wall thickness of the vein [which?] is significantly increased in venous reflux, being approximately 0.58 mm in venous reflux, compared to up to 0.45 mm normally. [36]