Image-guided central venous catheters for apheresis

Area of Science:

• Interventional Radiology
• Hematology
• Nephrology

Background:

• Apheresis is crucial for various conditions, but central venous catheter (CVC) placement carries risks.
• Peripheral access is sometimes used due to concerns about CVC complications.
• This study evaluates a specific CVC placement technique for apheresis.

Purpose of the Study:

• To determine the safety and success rate of ultrasound and fluoroscopically guided, non-tunneled dual lumen CVCs for apheresis.
• To assess complications associated with this specific CVC placement method.
• To evaluate the efficacy of real-time sonographic guidance in CVC placement for apheresis.

Main Methods:

• Prospective data collection of 200 attempted CVC placements using real-time sonographic guidance.
• Recording of placement complications, number of passes, and venepuncture success (single pass, anterior wall puncture).
• Documentation of catheterization duration and reasons for removal, including a cohort of stem cell donors.

Main Results:

• 100% successful CVC placement in all 200 patients (191 internal jugular, 7 femoral).
• High success rates: 86.5% single pass, 80.5% anterior wall puncture.
• Minimal complications: 3% inadvertent arterial puncture (clinically insignificant), no other procedure-related issues. 87.4% removed same day.

Conclusions:

• Ultrasound and fluoroscopically guided CVC placement is a safe and successful method for apheresis.
• Real-time sonographic guidance and short catheterization duration are key to minimizing complications.
• This technique offers a viable alternative to peripheral access for apheresis procedures.