Central Venous Access, Catheter Placement and Removal

Frequently Asked Questions

Q. What is a central venous catheter?

A. A CVC is a long thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more. A CVC is often inserted in the arm or chest through the skin into a large vein. The catheter is threaded through the vein until it reaches a large vein near the heart.

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Central Venous Access Procedures

We perform a variety of central venous access procedures at American Access Care of Baltimore.

Catheter Placement and Removal

Central venous access catheters (CVAC) are used for a variety of reasons, including hemodialysis. At American Access Care of Baltimore, catheterwe insert catheters using interventional radiology placement rather than surgical techniques. It’s a more effective and more comfortable, as well as much safer and shorter, procedure.

The rate of successful placement with image guided techniques approaches 100 percent, compared to 44 percent – 74 percent for surgical placement via cutdown of the cephalic vein, and 92 percent – 100 percent for other surgical techniques. Modern angiographic materials provide improved safety and efficacy during access to the venous system, compared with historical access procedures. Use of small needles, guide wire and sheath use, better access devices, and the use of ultrasound or contrast-enhanced fluoroscopic guidance techniques that allow accurate visualization of the target vein also improve success.

Interventional radiology techniques allow for greater precision. With fluoroscopic guidance, the catheter tip can be directed into the optimal position within the venous system. By avoiding surgical cutdown techniques, which are more likely to result in sacrifice of the vein, radiologic placement preserves future access and decreases your discomfort.

Other advantages include shortened procedure times and decreased costs. Performing the procedure the interventional radiology suite typically requires one third to one-half the time needed for surgical placement.

Dialysis/pheresis catheters are used to "clean" the blood in patients with kidney failure requiring hemodialysis or patients with immune diseases requiring plasma pheresis. These treatments require rapid flow of blood in and out of the body, and, thus, the catheters tend to be relatively large in diameter (approximately 4mm).

Percutaneous placement of catheters requires venous access, tunnel formation, and positioning of the catheter within the central venous system. Venous access is typically guided with fluoroscopy and ultrasound. Conventional central venous access sites include the internal jugular and common femoral veins.

Chest/Arm Ports

An implanted venous access device is a permanent vascular device consisting of a catheter attached to a small reservoir, which is implanted beneath the skin in the arm or chest. The device is used primarily when intravenous access is required for long-term intermittent therapy. Devices may be single or double lumen and septum. These devices offer appropriate access for chemotherapy, fluids, blood and blood products, parental nutrition, and for obtaining blood specimens for lab work. Port access and care is performed by one of our nurses. The venous access device, or port, is placed in the radiology suite under sterile conditions.

IVC Filter Placement

In patients in whom blood thinners are not medically appropriate to thin blood clots in veins, an interventional radiologist can place a device called a filter that captures blood clots and prevents them from traveling to the lungs but permits blood to pass. The filter is placed via a vein in the groin or neck. It is done with local anesthesia and can be performed with or without sedation. Some filters are designed so they can be removed when no longer needed. Like placement of the filter, this procedure is performed via a vein in the neck or groin.

Need more information or would like to request an appointment? Call 410-931-9729 today.