Bonasso Patrick C, Budi Stevan, Jones Brendan, Pillai Lakshmikumar
Department of Vascular Surgery, West Virginia University, Morgantown, WV.
J Vasc Surg Cases Innov Tech. 2020 Mar 3;6(1):156-159. doi: 10.1016/j.jvscit.2020.01.010. eCollection 2020 Mar.
This study presents the technique of percutaneous wire-target access of the superior vena cava (SVC) in patients with bilateral jugular-subclavian vein occlusion requiring a tunneled hemodialysis catheter. A 3-year retrospective review of five patients was performed. The femoral vein is accessed percutaneously and a 5F sheath inserted. This is followed by placement of a pigtail catheter (wire-target) in the SVC with cavography. The SVC is percutaneously cannulated at the level of the pigtail under fluoroscopy, and a guidewire is passed into the vena cava with confirmation by injection of contrast material. A tunneled hemodialysis catheter is then placed. The wire-target technique of SVC access can be used safely and effectively to establish upper body catheter access when traditional techniques are not possible.
本研究介绍了在双侧颈内静脉 - 锁骨下静脉闭塞且需要置入带隧道的血液透析导管的患者中，经皮导线引导进入上腔静脉（SVC）的技术。对5例患者进行了为期3年的回顾性研究。经皮穿刺股静脉并插入一个5F鞘管。随后在SVC内放置猪尾导管（导线引导）并进行腔静脉造影。在透视引导下于猪尾导管所在水平经皮穿刺SVC，注入造影剂确认后将导丝送入腔静脉。然后置入带隧道的血液透析导管。当传统技术不可行时，导线引导技术可安全有效地用于建立上半身的导管通路。
