Central venous catheter
Updates to Article Attributes
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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 medical, surgical, anaesthetic/ITU, or radiology specialists.
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
- infusothorax
- arrhythmia
- infection
- mediastinal haematoma
- infusothorax
- arterial placement
- perforation of vein needing a stent
- pinch off syndrome
- retained guidewire
- guidewire shearing and fragment embolisation
- malposition of port and tip
- Azygous termination
- retained hub
-<a href="/articles/malposition">malposition</a><a title="malposition of port and tip" href="/articles/malposition-of-port-and-tip"> of port and tip</a>- +<a href="/articles/malposition">malposition</a><a href="/articles/malposition-of-port-and-tip"> of port and tip</a>
Images Changes:
Image 1 X-ray (Frontal) ( update )
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Case 1: permacathPermcath
Image 16 X-ray (Frontal) ( update )
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Case 16:Left suclavian: left subclavian arterial line
Image 18 X-ray (Frontal) ( update )
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Case 17: Retained fragment of port a catheterPort-a-Cath
Image 19 X-ray (Lateral) ( update )
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Case 18: Tunneledtunnelled left IJ chemotherapy port tip terminates within the azygosinternal jugular vein Port-a-Cath with azygous vein termination
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