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[The external left jugular vein as an access for placement of long-term permanent central venous catheters in
Insights
The left external jugular vein approach for central venous catheter placement in pediatric patients is more successful than the right external jugular vein approach. This technique simplifies and speeds up catheter insertion, reducing the need for alternative methods.
Area of Science:
- Vascular Access
- Pediatric Surgery
- Medical Devices
Context:
- Central venous catheters (CVCs) are crucial for long-term medication delivery and monitoring in pediatric patients.
- The Heinbach-Ivey technique is a common method for CVC insertion.
- Choosing the optimal insertion site is vital for procedural success and patient safety.
Purpose:
- To compare the efficacy and success rates of using the left external jugular vein versus the right external jugular vein for central venous catheter placement via the Heinbach-Ivey technique in pediatric patients.
- To evaluate the impact of anatomical variations on procedural outcomes.
Summary:
- A retrospective study compared CVC placement using the Heinbach-Ivey technique through the left external jugular vein (n=72) versus the right external jugular vein (n=65) in pediatric patients.
- Initial attempts using the right external jugular vein had a 24.6% failure rate, necessitating placement via the right internal jugular vein.
- Subsequent use of the left external jugular vein approach resulted in a significantly lower failure rate of 6%.
Impact:
- The left external jugular vein approach offers a more favorable anatomical pathway, leading to easier and quicker central venous catheter placement in pediatric patients.
- This improved success rate can reduce procedure time, patient discomfort, and the need for more invasive alternative venous access methods.
- Findings suggest optimizing surgical technique by prioritizing the left external jugular vein for improved outcomes in pediatric central venous access.
Abstract:
We consider the approach through the left external jugular vein v/s right external jugular vein (Heinbach-Ivey technique) for the placement of central venous catheters (Broviac Hickman type and others) in pediatric patients. Between January '84 and February '87, 65 central venous catheters were inserted using the Heinbach Ivey technique. In 24.6% of the cases we failed and had to place the catheter through the right internal jugular vein. Between March '87 and November '88, 72 catheters were inserted through the left external jugular vein, only 5 through the left internal jugular vein, with a failure rate of 6%. Our data show that a more favourable anatomy makes easier and quicker the correct placement of a central venous catheter through a left external jugular vein approach.