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Clin Anat. 2008 Mar;21(2):106-10. doi: 10.1002/ca.20605.

Anatomical basis of central venous catheter fracture.

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1
Department of Surgery, School of Medicine and Health Sciences, University of North Dakota, Veteran's Administration Medical Center, Fargo, North Dakota 58102, USA. mark_jensen@und.nodak.edu

Abstract

Central venous catheter fracture is a rare complication of long-term indwelling subclavian venous access. Subclavian vein access has been the recommended approach for placing central venous catheters. The anatomical landmark method for subclavian access remains a highly successful and nonequipment-dependent method for rapid central access. More recently, the internal jugular vein approach has emerged as the preferred route for long-term central venous access. However, variations in internal jugular vein anatomy make the landmark method less reliable. Use of two-dimensional real-time ultrasound during internal jugular vein access is associated with better success, a lower complication rate, and faster access. A case of central venous catheter fracture initiated an internal review of long-term central venous access procedures. We have converted to a predominantly internal jugular vein approach. This case report and literature review may assist other physicians and institutions in re-evaluating long-term central venous access protocols.

PMID:
18288762
DOI:
10.1002/ca.20605
[Indexed for MEDLINE]
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