TY - JOUR
T1 - Applicability and feasibility of intraprocedural tip location of femorally inserted central catheters by transhepatic ultrasound visualization of the inferior vena cava in adult patients
AU - Annetta, Maria Giuseppina
AU - Marche, Bruno
AU - Giarretta, Igor
AU - Pittiruti, Mauro
PY - 2023
Y1 - 2023
N2 - Background: The ideal intraprocedural method for tip location during insertion of femorally inserted central catheters (FICCs) is still a matter of debate. When the catheter tip is meant to be in the right atrium or in the supradiaphragmatic inferior vena cava (IVC), tip location by either intracavitary electrocardiography or transthoracic echocardiography may be accurate and easy to perform. When the catheter tip is planned to be placed in the subdiaphragmatic IVC, fluoroscopy—though inaccurate and unsafe—has been regarded as the only option for intraprocedural tip location. Methods: We have investigated prospectively the applicability and feasibility of transhepatic ultrasound as intraprocedural method for assessing the location of the catheter tip in the subdiaphragmatic tract of IVC, during FICC insertion. Results: We enrolled 169 consecutive patients undergoing FICC insertion by ultrasound guided puncture of the superficial femoral vein. In 165 out of 169 patients, the subdiaphragmatic IVC was visualized by the transhepatic ultrasound view. In all cases of IVC visualization, the catheter tip could be identified by ultrasound, either directly (direct evidence of the tip inside the vein) or indirectly (enhanced visualization of the tip after “bubble test”). There was no immediate or early complication, and very few late complications. Conclusion: The intraprocedural method of tip location of FICCs by transhepatic ultrasound was applicable in 97.6% of cases and feasible in 100%. When the position of the catheter tip is planned to be in the subdiaphragmatic IVC, this method of tip location is accurate, safe, and inexpensive, and should be considered as an alternative to fluoroscopy.
AB - Background: The ideal intraprocedural method for tip location during insertion of femorally inserted central catheters (FICCs) is still a matter of debate. When the catheter tip is meant to be in the right atrium or in the supradiaphragmatic inferior vena cava (IVC), tip location by either intracavitary electrocardiography or transthoracic echocardiography may be accurate and easy to perform. When the catheter tip is planned to be placed in the subdiaphragmatic IVC, fluoroscopy—though inaccurate and unsafe—has been regarded as the only option for intraprocedural tip location. Methods: We have investigated prospectively the applicability and feasibility of transhepatic ultrasound as intraprocedural method for assessing the location of the catheter tip in the subdiaphragmatic tract of IVC, during FICC insertion. Results: We enrolled 169 consecutive patients undergoing FICC insertion by ultrasound guided puncture of the superficial femoral vein. In 165 out of 169 patients, the subdiaphragmatic IVC was visualized by the transhepatic ultrasound view. In all cases of IVC visualization, the catheter tip could be identified by ultrasound, either directly (direct evidence of the tip inside the vein) or indirectly (enhanced visualization of the tip after “bubble test”). There was no immediate or early complication, and very few late complications. Conclusion: The intraprocedural method of tip location of FICCs by transhepatic ultrasound was applicable in 97.6% of cases and feasible in 100%. When the position of the catheter tip is planned to be in the subdiaphragmatic IVC, this method of tip location is accurate, safe, and inexpensive, and should be considered as an alternative to fluoroscopy.
KW - Femorally inserted central catheter
KW - inferior vena cava
KW - ultrasound
KW - tip location
KW - transhepatic ultrasound
KW - superficial femoral vein
KW - Femorally inserted central catheter
KW - inferior vena cava
KW - ultrasound
KW - tip location
KW - transhepatic ultrasound
KW - superficial femoral vein
UR - http://hdl.handle.net/10807/262539
U2 - 10.1177/11297298231153979
DO - 10.1177/11297298231153979
M3 - Article
SN - 1129-7298
VL - 2023
SP - 11297298231153979-N/A
JO - Journal of Vascular Access
JF - Journal of Vascular Access
ER -