The journal of vascular access · 2026
An alternative to inside-out access for central venous catheter placement in thoracic central vein obstruction.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ierardi Anna Maria, Biondetti Pierpaolo, Ascenti Velio, Angileri Salvatore Alessio, Torcia Pierluca, Lanza Carolina, Pellegrino Giuseppe, Papa Sergio, Carrafiello Gianpaolo
Аннотация
PURPOSE: To evaluate feasibility, technical success, and safety of a fluoroscopy-guided percutaneous technique for central venous catheter (CVC) placement in patients with thoracic central venous obstruction (TCVO).
MATERIALS AND METHODS: We retrospectively included 16 adult and pediatric patients with TCVO requiring CVC placement. Technical success was defined as successful venous access and catheter placement; clinical success as functional catheter use without failure. Safety was assessed using CIRSE classification. Procedural metrics were recorded. Descriptive statistics (median, IQR; counts, %) were used. Exploratory comparisons between obstruction type (Type 1-2B vs 3-4) and procedural metrics were performed using Mann-Whitney U test.
RESULTS: Seventeen procedures were performed in 16 patients (median age 27.5 years, range 7-61; 11 males). Access and catheter placement succeeded in 16/17 procedures (94.1%) and all patients (100%). In one case, first attempt failed and a second successful procedure was requested. First-attempt per-patient technical success was 93.7%. Clinical success was 100%. No major complications occurred; minor adverse events (CIRSE grade 1) were observed in three patients (18.7%). Median procedure time 52 min, fluoroscopy 12 min and 5 s, contrast 46 mL, and DAP 91.3 Gy/cm2. Trend toward longer procedure time was noted for Type 3-4 obstructions and collateral snare use.
CONCLUSION: Fluoroscopy-guided percutaneous CVC placement is feasible and safe in TCVO using the described technique and may represent a widely applicable alternative to dedicated inside-out system.
MATERIALS AND METHODS: We retrospectively included 16 adult and pediatric patients with TCVO requiring CVC placement. Technical success was defined as successful venous access and catheter placement; clinical success as functional catheter use without failure. Safety was assessed using CIRSE classification. Procedural metrics were recorded. Descriptive statistics (median, IQR; counts, %) were used. Exploratory comparisons between obstruction type (Type 1-2B vs 3-4) and procedural metrics were performed using Mann-Whitney U test.
RESULTS: Seventeen procedures were performed in 16 patients (median age 27.5 years, range 7-61; 11 males). Access and catheter placement succeeded in 16/17 procedures (94.1%) and all patients (100%). In one case, first attempt failed and a second successful procedure was requested. First-attempt per-patient technical success was 93.7%. Clinical success was 100%. No major complications occurred; minor adverse events (CIRSE grade 1) were observed in three patients (18.7%). Median procedure time 52 min, fluoroscopy 12 min and 5 s, contrast 46 mL, and DAP 91.3 Gy/cm2. Trend toward longer procedure time was noted for Type 3-4 obstructions and collateral snare use.
CONCLUSION: Fluoroscopy-guided percutaneous CVC placement is feasible and safe in TCVO using the described technique and may represent a widely applicable alternative to dedicated inside-out system.