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A peripherally inserted central catheter, or PICC line (pronounced "pick"), is a central venous catheter inserted into a vein in the arm (via the basilic or cephalic veins) rather than a vein in the neck or chest. The basilic vein is usually a better target for cannulation than the cephalic vein because it is larger and runs a straighter course ...
Prior to the description of the Seldinger technique, sharp trocars were used to create lumens through which devices could be passed. This had a high rate of complications. [ 4 ] However, with the introduction of the Seldinger technique, angiography became a relatively risk-free procedure, and the field of interventional radiology blossomed.
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.
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vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
The most common complications are: catheter blockage (7.4%), and catheter-related infection (5.6%). Other complications are: malpositioning of the catheter, venous thrombosis, catheter leak or dislodgement. [3] The common carotid artery may be injured during the puncture of the internal jugular vein as the artery lies close to the vein.
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.
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It is most commonly placed in the neck (internal jugular) but may also be placed in the groin (femoral), liver (transhepatic), chest (subclavian) or back (translumbar). [3] The catheter is inserted into the vessel under ultrasound or fluoroscopic guidance and tunneled through the skin. Tunneled catheters have multiple channels called lumens ...