Inferior vena cava: translumbar catheterization for central venous access

Area of Science:

• Vascular Surgery
• Interventional Radiology

Background:

• Central venous access is crucial for long-term therapies.
• Thrombosis of usual access sites presents a significant clinical challenge.
• Alternative methods for venous access are essential for patient management.

Purpose of the Study:

• To evaluate the safety and success of translumbar inferior vena cava catheterization.
• To assess the efficacy of this technique in patients with thrombosed conventional access routes.

Main Methods:

• Translumbar inferior vena cava catheterization was performed in six patients requiring long-term central venous access.
• Seven procedures were conducted using various catheter sizes (7-F to 12-F Silastic catheters).
• Patient demographics included ages from 2 to 76 years, with a 2:1 male to female ratio.

Main Results:

• Catheter placement was successful and uncomplicated in all seven procedures.
• Functioning catheters were maintained for extended periods (up to 32 months) in surviving patients.
• Complications included sepsis requiring catheter removal in one patient (twice).
• Mortality in two patients was attributed to underlying conditions (metastatic breast cancer, AIDS).

Conclusions:

• Translumbar inferior vena cava catheterization is a safe and effective alternative for patients with thrombosed central venous access sites.
• The technique provides durable venous access, even in challenging clinical scenarios.
• Careful patient selection is key to optimizing outcomes with this interventional approach.