Central venous catheter
Updates to Article Attributes
Body
was changed:
Central venous catheters (CVC) or lines (CVL) refer to a wide range of central venous access devices but can broadly be divided into four categories. They may be inserted by physicians, surgeons or radiologists.
Classification
- peripherally inserted central catheters (PICC)
- non-tunnelled CVCs
- e.g. used in ICU or ED for emergent or short-term (<7-10 days) access
- e.g. Vascath used for haemodialysis, apheresis, stem cell collection, etc
- tunnelled CVCs
- e.g. Hickman catheters, Broviac line, Permcath
- implantable ports
- e.g. Port-a-Cath, Infus-a-Port
- may be located in the chest or arm (brachial)
- may be single or dual lumen
Site
Central venous catheters can be inserted into a variety of veins, most commonly including:
- internal jugular vein (see: jugular venous catheters)
- subclavian vein
- femoral vein (typically only short-term access)
- brachial, basilic or cephalic veins (for PICCs and implantable ports)
Placement
Policy varies by institution but tip placement for neck / thoracic / upper limb CVCs in the superior vena cava or at the cavo-atrial junction is generally acceptable. There is a limited differential of left paramediastinal catheter positions.
Complications
- pneumothorax
- haemothorax
- infection
- mediastinal haematoma
- infusothorax
- arterial placement
- perforation of vein needing a stent
- pinch off syndrome
- retained guidewire
- guidewire shearing and fragment embolisation
-<li>perforation of vein needing stent</li>-<li><a title="Pinch off syndrome" href="/articles/pinch-off-syndrome">pinch off syndrome</a></li>- +<li>perforation of vein needing a stent</li>
- +<li><a href="/articles/pinch-off-syndrome">pinch off syndrome</a></li>
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