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The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
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Central venous catheters tip positioning: Insights from a retrospective analysis
Annalisa Noce1,2, Sara Dominijanni3, Giulia Marrone1
1Department of Systems Medicine, University of Tor Vergata, Rome, Italy.
The Journal of Vascular Access
|August 29, 2025
Summary
Accurate placement of tunneled central venous catheters (tCVCs) is vital for hemodialysis. Fluoroscopy may misjudge optimal tip position, highlighting the need for advanced imaging and AI to improve outcomes and reduce complications like stenosis.
Area of Science:
- Nephrology
- Vascular Access
- Medical Imaging
Background:
- Tunneled central venous catheters (tCVCs) are critical for hemodialysis when other access is not possible.
- Correct tCVC positioning is essential for effective dialysis and preventing complications like stenosis and thrombosis.
Purpose of the Study:
- To evaluate the accuracy of fluoroscopy-guided tCVC tip positioning.
- To assess the incidence of complications, such as central venous stenosis, related to tCVC placement.
- To explore the impact of catheter tip malposition on patient outcomes.
Main Methods:
- Retrospective, non-randomized study of 1238 tCVC placements from January 2017 to December 2024.
- Data collected on catheter tip position under fluoroscopy and subsequent complications.
- Analysis of central venous stenosis incidence and treatment requirements.
Main Results:
- 83% of tCVCs were placed in the right internal jugular vein.
- Fluoroscopy showed 9.8% of tips above the right atrium (RA), 44.5% within, and 45.5% below.
- Central venous stenosis occurred in 18.8% of patients, with 2.4% needing stents.
Conclusions:
- Precise tCVC tip positioning is critical for maintaining patency and minimizing complications.
- Fluoroscopy may underestimate anatomical boundaries, suggesting potential discrepancies with CT evaluations.
- Advanced imaging, AI, and individual patient factors are key to improving procedural accuracy and safety.
Keywords:
Tunneled central venous catheterartificial intelligence in nephrologycatheter tip positioninghemodialysis vascular accessMore Related Videos
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