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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vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
Choice of route depends mainly on the number and location of any blood clot within the venous system. To place the filter, a catheter is guided into the IVC using fluoroscopic guidance, then the filter is pushed through the catheter and deployed into the desired location, usually just below the junction of the IVC and the lowest renal vein. [44]
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 ...
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 ...
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.
Femoropopliteal bypass surgery is mainly used to treat cases of femoral artery blockage that cause more severe symptoms that restrict completion of daily tasks such as peripheral artery disease and claudication, or cases that have not responded well to other treatment options . Before surgery is considered, adjustments are made to lifestyle ...
A valvulotome is a catheter-based controllable surgical instrument used for cutting or disabling the venous valves. [1] This is needed to enable an in situ bypass in patients with an occluded artery (especially femoral artery), where the saphenous vein is disconnected from the venous system and connected to arteries above and below the occluded segment to allow blood to flow to the lower leg.
The lack of an adequate venous conduit is a relative contraindication to bypass surgery, and depending on the area of disease, alternatives may be used. Medical conditions such as ischemic heart disease or chronic obstructive pulmonary disease that increase the risk of surgery are also relative contraindications. For coronary and peripheral ...