■小口径中心静脉导管的股腹部隧穿是一种床边技术,适用于有禁忌症的患者胸腔入路,或作为下肢导管出口部位的替代方案。
■对接受有胸静脉入路禁忌症或下肢导管出口部位的中长期静脉内治疗的患者实施了股骨至腹部隧道技术。在局部麻醉下在超声引导下插入所有静脉接入装置。和导管尖端放置通过术后射线照相术评估。
■在这种情况下,从2020年1月到2023年1月,总共插入了8个FTA隧道式静脉接入设备。有七名卧床病人和一名卧床病人。皮下隧道的中位长度为20厘米,范围从15到27厘米。静脉导管至末梢的中位长度为31厘米,范围从23到40厘米。术后腹部X线片确认尖端位置。导管尖端位置被解释为在T8-T9(2)水平,T12(1),L4(2),L2(2),L1(1).未报告插入或插入后相关并发症。六名患者完成了预定的静脉治疗。一名患者由于转移到外部设施而无法追踪。最初证明在左髂总血管上盘绕的一根导管使用高流量冲洗技术重新定位。据报道,提供护理和维护的护士有导管移位。总体植入天数为961天,中位停留时间为125天,范围为20至399天。
■股骨至腹部隧道术提供了一种替代的出口部位,可用于选择具有复杂静脉通路的患者。这项小型回顾性研究的数据表明,这是一种安全且微创的床边手术。
UNASSIGNED: Femoral to abdomen tunneling of small-bore central venous catheters is a bedside technique for patients with contraindications to a thoracic approach, or as an alternative to a lower extremity catheter exit site.
UNASSIGNED: A femoral to abdomen tunneling technique was implemented for patients receiving medium and long-term intravenous treatments with contraindications to the thoracic venous approach or as an alternative to a lower extremity catheter exit site. All venous access devices were inserted with ultrasound guidance under local anesthesia, and catheter tip placement assessed by post procedural radiography.
UNASSIGNED: In this case series, from January 2020 to January 2023, a total of eight FTA-tunneled venous access devices were inserted. There were seven ambulatory patients and one bedbound patient. The median length of the subcutaneous tunnel was 20 cm, ranging from 15 to 27 cm. The median length of the intravenous catheter to the terminal tip was 31 cm, ranging from 23 to 40 cm. Tip location was confirmed by post-procedural abdominal radiograph. The catheter tip locations were interpreted to be at the level of T8-T9 (2), T12 (1), L4 (2), L2 (2), L1(1).No insertion or post insertion related complication was reported. Six patients completed the scheduled intravenous treatment. One patient was unable to be tracked due to transfer to an outside facility. One catheter initially demonstrated to be coiled over the left common iliac vessel was repositioned using a high flow flush technique. There was one reported catheter dislodgment by the nurse providing care and maintenance. The overall implant days were 961, with a median dwell time of 125 days ranging from 20 to 399 days.
UNASSIGNED: Femoral to abdomen tunneling provides an alternative exit site useful in select patients with complex intravenous access. The data of this small retrospective review suggests this a safe and minimally invasive bedside procedure.