Ultrasound-guided double central venous access for azygos vein via the ninth and tenth intercostal veins.

Ultrasound-guided double central venous access for azygos vein via the ninth and tenth intercostal veins. J Vasc Access. 2020 Jun 30;:1129729820937133 Authors: Yoshimaru K, Matsuura T, Uchida Y, Kajihara K, Toriigahara Y, Kawano Y, Kondo T, Takahashi Y, Matsuoka W, Kaku N, Maki J, Taguchi T Abstract Some patients with intestinal failure, who are dependent on total parenteral nutrition for long periods, suffer from a lack of suitable conventional venous access points, including axillary, external jugular, internal jugular, subclavian, saphenous, and the brachio-cephalic and femoral veins, due to their occlusion. Furthermore, extensive central venous stenosis and/or thrombosis of the superior and inferior vena cava may preclude further catheterization, so uncommon routes must be used, which can be challenging. In such patients, the azygos vein via the intercostal vein is a viable candidate. Thoracotomy-assisted, thoracoscopy-assisted, and cut-down procedures are currently suggested such access. We found that ultrasound-guided percutaneous puncture method was a safe and minimally invasive approach and successfully placed two central venous lines in preparation for small bowel transplantation via two different intercostal veins (ninth and tenth). Although the lung was actually located just below the target veins, an ultrasound provided augmented and clear vision, which contributed to the safe performance of the procedure without the need...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research