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Push-pull monorail technique to overcome a difficult course through the left internal jugular vein
Su Ho Kim1, Byung Gil Choi1, Chang Ho Jeon2
1Department of Radiology, 65570Seoul St Mary's Hospital, College of Medicine, 65644The Catholic University of Korea, Seocho-Ku, Seoul, Korea.
Science Progress
|December 21, 2022
Summary
The push-pull monorail technique successfully navigated challenging left internal jugular vein anatomy for implantable port placement. This method achieved a 100% technical success rate without complications in patients with difficult venous access.
Area of Science:
- Interventional Radiology
- Vascular Access Procedures
Background:
- Implantable port insertion can be challenging due to complex venous anatomy.
- The left internal jugular vein presents specific anatomical difficulties for port placement.
Purpose of the Study:
- To evaluate the efficacy of a novel push-pull monorail technique.
- To overcome anatomical challenges during left internal jugular vein port insertions.
Main Methods:
- A push-pull monorail technique was employed in 8 patients with catheter tips in the azygos vein.
- The technique involves micropuncture needle insertion, guidewire advancement, and microsheath use.
- This method provides support for port advancement and prevents catheter extrusion.
Main Results:
- The push-pull monorail technique demonstrated a 100% technical success rate.
- All 8 cases utilizing this method were technically successful.
- No immediate or delayed complications were observed in the study cohort.
Conclusions:
- The push-pull monorail technique is an effective solution for difficult implantable port insertions.
- This method facilitates overcoming challenging anatomical courses in the left internal jugular vein.
- The technique offers a safe and successful approach to venous access.
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