Temporary atypical vascular ultrasound-guided central venous approach in patients with venous occlusion

This study presents an innovative ultrasound-guided technique for central venous access in patients with venous occlusion, particularly in those requiring long-term parenteral nutrition (TPN). Conventional access points often become occluded, necessitating alternative methods for approaching the central vein. A retrospective review of three patients with venous occlusion due to prolonged TPN use was conducted at our institution. The procedure involved ultrasound-guided puncture of atypical vessels, such as the internal mammary, anterior jugular, or innominate veins, using the Seldinger or introducer technique depending on vessel size. All catheters were successfully placed with minimal complications, allowing for continued TPN. The study concluded that ultrasound-guided access to atypical vessels offers a safer and less invasive alternative to central venous access in complex cases, particularly in adolescent and young adult patients.