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Apheresis: another indication for radiologically placed central venous catheters
D J Sadler1, J C Saliken, C B So
1Department of Diagnostic Imaging, Foothills Hospital, University of Calgary, Alta.
Summary
Radiologic placement of central venous catheters (CVCs) using real-time guidance is safe and successful for apheresis. This technique minimizes complications, ensuring efficient patient treatment and donor collection.
Area of Science:
- Interventional Radiology
- Hematology
- Oncology
Background:
- Apheresis is increasingly utilized for various medical conditions.
- Central venous catheter (CVC) placement is a common method for apheresis access.
- Concerns exist regarding complications associated with traditional CVC placement, prompting investigation into alternative methods.
Purpose of the Study:
- To evaluate the safety and efficacy of radiologic placement of CVCs for apheresis procedures.
- To determine complication rates and success of CVC insertion under image guidance.
Main Methods:
- Prospective data collection for 278 CVC placements under sonographic or fluoroscopic guidance.
- Documentation of all complications, venipuncture passes, and puncture details.
- Recording of catheter dwell time and reasons for removal.
Main Results:
- Successful CVC placement in all patients (n=278), primarily in the internal jugular vein.
- High success rate with single-pass venipuncture (87%) and single anterior wall puncture (80%).
- Low complication rate, including clinically insignificant arterial puncture (2%) and premature removal (1%).
Conclusions:
- Central venous catheters (CVCs) are safe and effective for apheresis when placed using real-time sonographic guidance and fluoroscopic confirmation.
- Minimizing catheter dwell time is crucial for maintaining safety.
- Radiologic guidance enhances procedural success and reduces complications in apheresis CVC placement.