Vascular Access Unit, ASST Spedali Civili, Brescia, Italy.
Department of Pediatric Surgery, ASST Spedali Civili "Children Hospital," Brescia, Italy.
J Vasc Access. 2024 Nov;25(6):2018-2022. doi: 10.1177/11297298231191367. Epub 2023 Aug 17.
Axillary vein in the brachial tract or Basilic vein in the proximal third of the arm has got usually an enough diameter to receive a catheter of 4 or 5 Fr. In this case the exit site should be too proximal to the axilla with an higher risk of infection. Pseudo-tunneling procedure can create an exit site at the middle of the arm without using tunnelers during insertion of Peripherally Inserted Central Catheters and Midlines in patients who present deep veins of the arm too small to receive a catheter to consent infusion and blood samples.
The aim of this study is to present our experience with pseudo-tunneling procedure, also using a particular variation of the technique.
From January 2014 to August 2022 150 Peripherally Inserted Central Catheters and 221 Midlines were insert in pediatric and adults patients with too small deep veins at the middle third of the arm with this technique by the same trained team of Vascular Access Unit at ASST Spedali Civili Hospital of Brescia.
All procedures were successfully performed at the first or at the second attempt. No insertion related complications were observed.
Our data suggest pseudo-tunneling technique is a safe and effective procedure for of Peripherally Inserted Central Catheters and Midline insertion avoiding central venous catheterization even in patient with small vein at the arms.
在臂丛中的腋静脉或近段三分之一的贵要静脉通常有足够的直径来容纳 4 或 5Fr 的导管。在这种情况下，出口部位应该过于靠近腋窝，感染风险较高。假性隧道技术可以在不使用隧道器的情况下，在手臂中段创建一个出口部位，以便在手臂深部静脉过小无法容纳导管进行输注和血液样本采集的患者中插入外周中心静脉导管和中线。
本研究旨在介绍我们使用假性隧道技术的经验，同时也介绍了该技术的一种特殊变化。
自 2014 年 1 月至 2022 年 8 月，血管通路小组的同一位训练有素的团队在布雷西亚 ASST Spedali Civili 医院的儿科和成人患者中，使用这种技术在手臂中段深部静脉过小的情况下，对 150 例外周中心静脉导管和 221 例中线进行了插入。
所有手术均在第一次或第二次尝试时成功完成。未观察到与插入相关的并发症。
我们的数据表明，假性隧道技术是一种安全有效的外周中心静脉导管和中线插入技术，即使在手臂静脉较小的患者中，也可以避免中心静脉置管。
