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Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Related Experiment Video

Updated: May 27, 2026

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
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Venous access salvage techniques.

Donald F Denny1

  • 1Princeton Radiology Associates, PA, USA. ddenny@prapa.com

Techniques in Vascular and Interventional Radiology
|November 22, 2011
PubMed
Summary

Salvage venous access techniques provide effective solutions for long-term central venous access when standard veins are blocked. These methods, including translumbar and transhepatic inferior vena cava access, offer durable and successful alternatives for both adults and children.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Nephrology

Background:

  • Patients requiring long-term central venous access often face central vein obstruction.
  • Standard central venous access routes may become unavailable due to thrombosis or stenosis.
  • Alternative "salvage" techniques are crucial for establishing venous access in challenging cases.

Purpose of the Study:

  • To review and summarize salvage venous access techniques for patients with central vein obstruction.
  • To highlight the efficacy, safety, and durability of these alternative access methods.
  • To discuss the types of devices that can be placed using these techniques.

Main Methods:

  • Translumbar inferior vena cava (IVC) access
  • Transhepatic inferior vena cava (IVC) access

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  • Catheterization of small venous collaterals
  • Recanalization of occluded veins

    • Main Results:

    • Salvage techniques offer successful alternatives for central venous access.
    • A range of devices, including ports, infusion catheters, and hemodialysis catheters, can be placed.
    • High success rates and infrequent complications are reported for these methods.
    • Access routes demonstrate general durability for long-term use.

    Conclusions:

    • Salvage venous access techniques are effective and safe for patients with central vein obstruction.
    • These methods provide durable solutions for long-term venous access in adults and children.
    • Careful patient selection and technique are important for optimal outcomes.