Download PDF
Interventionelle Radiologie Scan 2015; 03(01): 51-73
DOI: 10.1055/s-0034-1391348
Fortbildung
© Georg Thieme Verlag KG Stuttgart · New York

Venöse Zugänge – Implantation und Komplikationsmanagement

Bernhard Gebauer
Further Information

Publication History

Publication Date:
02 March 2015 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Bedeutung der interventionellen Radiologie bei der Implantation und dem Management von Komplikationen von zentralvenösen Kathetern hat deutlich zugenommen. Da die Indikationen und Einsatzgebiete der Katheter sehr unterschiedlich sind, haben sich viele verschiedene Kathetertypen entwickelt, deren Implantationstechnik, Einsatzgebiet und Spektrum an möglichen Komplikationen sehr unterschiedlich sind. Die verschiedenen Katheter und deren Besonderheiten werden im Artikel vorgestellt. Beim Management von Katheterkomplikationen ist die interventionelle Radiologie durch ihre diagnostischen und interventionellen Methoden ein idealer Partner und kann bei langfristigen Kathetern dem Patienten viele Optionen bieten den Katheter zu bewahren. Diese werden diskutiert und erläutert.

 

  • Literatur

  • 1 Forssmann W. Die Sondierung des rechten Herzens. Klin Wochenzeitschr 1929; 8: 3
    Google Scholar
  • 2 Gebauer B, Beck A, Wagner HJ. Zentralvenöse Katheter: Diagnostik von Komplikationen und therapeutische Optionen. Radiologie up2date 2008; 8: 135-154
    Article in Thieme ConnectGoogle Scholar
  • 3 Shaldon S, Silva H, Pomeroy J et al. Percutaneous femoral venous catheterization and reusable dialysers in the treatment of acute renal failure. Trans Am Soc Artif Intern Organs 1964; 10: 133-135
    Google Scholar
  • 4 O’Grady NP, Alexander M, Burns LA et al. Summary of recommendations: Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52: 1087-1099
    CrossrefGoogle Scholar
  • 5 O’Grady NP, Alexander M, Dellinger EP et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 2002; 51: 1-29
    Google Scholar
  • 6 Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet 1973; 136: 602-606
    Google Scholar
  • 7 Hickman RO, Buckner CD, Clift RA et al. A modified right atrial catheter for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 1979; 148: 871-875
    Google Scholar
  • 8 Demers HG, Siebold G, Geyer G et al. Dialyse ohne Shunt. Siliconkatheter im rechten Vorhof. Nieren Hochdruckkrankh 1986; 15: 460-462
    Google Scholar
  • 9 Hoshal Jr VL. Total intravenous nutrition with peripherally inserted silicone elastomer central venous catheters. Arch Surg 1975; 110: 644-646
    CrossrefGoogle Scholar
  • 10 Pittiruti M, Scoppettuolo G, La Greca A et al. The EKG method for positioning the tip of PICCs: results from two preliminary studies. JAVA 2008; 13 : 7
    Google Scholar
  • 11 Vesely TM. Central venous catheter tip position: a continuing controversy. J Vasc Interv Radiol 2003; 14: 527-534
    CrossrefGoogle Scholar
  • 12 Food and Drug Administration Task Force. Precautions necessary with central venous catheters. FDA Drug Bulletin 1989; 19: 15-16
    Google Scholar
  • 13 National Association of Vascular Access Networks. NAVAN Position Statement. J Vasc Access Devices 1998; 3: 8-10
    Google Scholar
  • 14 Stonelake PA, Bodenham AR. The carina as a radiological landmark for central venous catheter tip position. Br J Anaesth 2006; 96: 335-340
    CrossrefPubMedGoogle Scholar
  • 15 National Kidney Foundation. III. NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: Update 2000. Am J Kidney Dis 2001; 37 (Suppl. 01) 137-S181
    CrossrefGoogle Scholar
  • 16 National Kidney Foundation. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for 2006 updates: Hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. Am J Kidney Dis 2006; 48: 322
    Google Scholar
  • 17 Calvert N, Hind D, McWilliams R et al. Ultrasound for central venous cannulation: economic evaluation of cost-effectiveness. Anaesthesia 2004; 59: 1116-1120
    CrossrefGoogle Scholar
  • 18 National Institute for Health and Care Excellence (NICE). Guidance on the use of ultrasound locating devices for placing central venous catheters 2002. Im Internet: http://www.nice.org.uk/guidance/ta49/resources/guidance-guidance-on-the-use-of-ultrasound-locating-devices-for-placing-central-venous-catheters-pdf (Stand: 10.12.2014)
    Google Scholar
  • 19 Gebauer B, El-Sheik M, Vogt M et al. Combined ultrasound and fluoroscopy guided port catheter implantation – high success and low complication rate. Eur J Radiol 2009; 69: 517-522
    CrossrefGoogle Scholar
  • 20 Gebauer B, Teichgraber UK, Podrabsky P et al. Ultraschall- und durchleuchtungsgesteuerte Implantation peripher inserierter zentral-venöser Katheter (PICC). Fortschr Röntgenstr 2004; 176: 386-391
    Article in Thieme ConnectGoogle Scholar
  • 21 Gebauer B, Teichgraber UM, Werk M et al. Sonographically guided venous puncture and fluoroscopically guided placement of tunneled, large-bore central venous catheters for bone marrow transplantation – high success rates and low complication rates. Support Care Cancer 2008; 16: 897-904
    CrossrefGoogle Scholar
  • 22 Silberzweig JE, Sacks D, Khorsandi AS et al. Reporting standards for central venous access. J Vasc Interv Radiol 2003; 14: 443-S452
    CrossrefGoogle Scholar
  • 23 Lenhart M, Schatzler S, Manke C et al. Radiologische Implantation zentralvenöser Portsysteme am Unterarm. Implantationsergebnisse und Langzeit-Follow-up bei 391 Patienten. Rofo 2010; 182: 20-28
    Article in Thieme ConnectGoogle Scholar
  • 24 Patel IJ, Davidson JC, Nikolic B et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012; 23: 727-736
    CrossrefGoogle Scholar
  • 25 Maurer MH, Beck A, Hamm B et al. Central venous port catheters: evaluation of patients’ satisfaction with implantation under local anesthesia. J Vasc Access 2009; 10: 27-32
    Google Scholar
  • 26 Gebauer B, Teichgraber U, Werk M et al. Periinterventionelle prophylaktische Antibiotikagabe bei der radiologischen Portkatheterimplantation. Rofo 2007; 179: 804-810
    Article in Thieme ConnectGoogle Scholar
  • 27 Metzler B, Hillebrand H, Eulenbruch HP et al. Persistent left superior vena cava with right-left shunt into the left atrium. Dtsch Med Wochenschr 2002; 127: 83-86
    Article in Thieme ConnectGoogle Scholar
  • 28 Yousaf M, Malak SF. Left atrial drainage of a persistent left superior vena cava. Radiol Case Reports 2008; 3: 4
    Google Scholar
  • 29 O’Grady NP, Alexander M, Burns LA et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52: e162-e193
    CrossrefGoogle Scholar
  • 30 Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut. Prävention Gefäßkatheter-assoziierter Infektionen. Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut (RKI). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2002; 45: 18
    Google Scholar
  • 31 Moureau N, Poole S, Murdock MA et al. Central venous catheters in home infusion care: outcomes analysis in 50.470 patients. J Vasc Interv Radiol 2002; 13: 1009-1016
    CrossrefGoogle Scholar
  • 32 Gebauer B, Teichgraber UK, Podrabsky P et al. Radiological interventions for correction of central venous port catheter migrations. Cardiovasc Intervent Radiol 2007; 30: 216-221
    CrossrefGoogle Scholar
  • 33 Food and Drug Administration (FDA). Reminders from FDA regarding ruptured vascular access devices from power injection 31.3.2013. Im Internet: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/TipsandArticlesonDeviceSafety/ucm070193.htm; Stand: 3.12.2014
    Google Scholar
  • 34 Hinke DH, Zandt-Stastny DA, Goodman LR et al. Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology 1990; 177: 353-356
    CrossrefGoogle Scholar
  • 35 Blom JW, Doggen CJ, Osanto S et al. Old and new risk factors for upper extremity deep venous thrombosis. J Thromb Haemos 2005; 3: 2471-2478
    Google Scholar
  • 36 Prandoni P, Polistena P, Bernardi E et al. Upper-extremity deep vein thrombosis. Risk factors, diagnosis, and complications. Arch Intern Med 1997; 157: 57-62
    CrossrefPubMedGoogle Scholar
  • 37 Joffe HV, Kucher N, Tapson VF et al. Upper-extremity deep vein thrombosis: a prospective registry of 592 patients. Circulation 2004; 110: 1605-1611
    CrossrefGoogle Scholar
  • 38 Heit JA, Silverstein MD, Mohr DN et al. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med 2000; 160: 809-815
    CrossrefPubMedGoogle Scholar
  • 39 Gaddh M, Antun A, Yamada K et al. Venous access catheter-related thrombosis in patients with cancer. Leukemia lymphoma 2014; 55: 501-508
    CrossrefGoogle Scholar
  • 40 Forauer AR, Theoharis CG, Dasika NL. Jugular vein catheter placement: histologic features and development of catheter-related (fibrin) sheaths in a swine model. Radiology 2006; 240: 427-434
    CrossrefGoogle Scholar
  • 41 Janne d’Othee B, Tham JC, Sheiman RG. Restoration of patency in failing tunneled hemodialysis catheters: a comparison of catheter exchange, exchange and balloon disruption of the fibrin sheath, and femoral stripping. J Vasc Interv Radiol 2006; 17: 1011-1015
    CrossrefGoogle Scholar
  • 42 Savader SJ, Ehrman KO, Porter DJ et al. Treatment of hemodialysis catheter-associated fibrin sheaths by rt-PA infusion: critical analysis of 124 procedures. J Vasc Interv Radiol 2001; 12: 711-715
    CrossrefGoogle Scholar
  • 43 Whigham CJ, Lindsey JI, Goodman CJ et al. Venous port salvage utilizing low dose tPA. Cardiovasc Intervent Radiol 2002; 25: 513-516
    CrossrefGoogle Scholar
  • 44 Forauer AR, Theoharis C. Histologic changes in the human vein wall adjacent to indwelling central venous catheters. J Vasc Interv Radiol 2003; 14: 1163-1168
    CrossrefPubMedGoogle Scholar
  • 45 Schillinger F, Schillinger D, Montagnac R et al. Post catheterisation vein stenosis in haemodialysis: comparative angiographic study of 50 subclavian and 50 internal jugular accesses. Nephrol Dial Transplant 1991; 6: 722-724
    CrossrefPubMedGoogle Scholar
  • 46 Maki DG, Weise CE, Sarafin HW. A semiquantitative culture method for identifying intravenous-catheter-related infection. New Engl J Med 1977; 296: 1305-1309
    CrossrefGoogle Scholar
  • 47 Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med 2000; 132: 391-402
    CrossrefGoogle Scholar
  • 48 Calandra T, Cohen J. The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 2005; 33: 1538-1548
    CrossrefGoogle Scholar
  • 49 Miller DL, O’Grady NP. Guidelines for the prevention of intravascular catheter-related infections: recommendations relevant to interventional radiology for venous catheter placement and maintenance. J Vasc Interv Radiol 2012; 23: 997-1007
    CrossrefGoogle Scholar
  • 50 Mermel LA, Allon M, Bouza E et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the infectious diseases society of america. Clin Infect Dis 2009; 49: 1-45
    CrossrefPubMedGoogle Scholar
  • 51 Bishop L, Dougherty L, Bodenham A et al. Guidelines on the insertion and management of central venous access devices in adults. Int J Lab Hematol 2007; 29: 261-278
    CrossrefGoogle Scholar
  • 52 Bouza E, Burillo A, Munoz P. Catheter-related infections: diagnosis and intravascular treatment. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases 2002; 8: 265-274
    CrossrefGoogle Scholar
  • 53 Hall K, Farr B. Diagnosis and management of long-term central venous catheter infections. J Vasc Interv Radiol 2004; 15: 327-334
    CrossrefGoogle Scholar
  • 54 Jauch KW, Schregel W, Stanga Z et al. Leitlinie Parenterale Ernährung der DGEM: Technik und Probleme der Zugänge in der parenteralen Ernährung. Aktuel Ernaehr Med 2007; 32: 12
    Google Scholar
  • 55 Vescia S, Baumgartner AK, Jacobs VR et al. Management of venous port systems in oncology: a review of current evidence. Ann Oncol 2008; 19: 9-15
    Google Scholar
  • 56 Widmer AF. Management of catheter-related bacteremia and fungemia in patients on total parenteral nutrition. Nutrition 1997; 13: 18S-25S
    CrossrefGoogle Scholar
  • 57 Wolf HH, Leithauser M, Maschmeyer G et al. Central venous catheter-related infections in hematology and oncology: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 2008; 87: 863-876
    CrossrefGoogle Scholar
  • 10 Niederhuber JE, Ensminger W, Gyves JW et al. Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 1982; 92(4): 706-712
    Google Scholar