Müller U S, Gräwe G, Bender F
Z Kardiol. 1979 Mar;68(3):180-2.
The industrial supply with complete venous catheter sets facilitated central venous techniques via various peripheral venous entries. The complication rate by pneumothorax, hemothorax, hemopericardium after perforation of a cardiac cavity and central embolism of catheter fragments are rather rare. Nevertheless the indication for central venous catheterization procedures should be calculated critically in every case because of the hazard of venous thrombosis and embolism or sepsis, which occurs more often. Perforation of a cardiac cavity by venous catheters leads to lethal sequelae in more than 60%. Central embolism of venous catheter fragments without perforation is followed by serious complications in most cases. Therefore the retrieval of the embolized fragment should be attempted by trasvenous technique or by thoracotomy. For the transvenous retrieval a special forceps or the transvenous Dotter retrieval set were very useful in our experience. Centrally embolized catheter fragments were drawn back in three patients after transcutaneous puncture via the femoral vein with two-plane X-ray control.
完整静脉导管套件的工业供应通过各种外周静脉入路促进了中心静脉技术的应用。气胸、血胸、心脏穿孔后心包积血以及导管碎片中心栓塞的并发症发生率相当低。然而,由于静脉血栓形成、栓塞或败血症等更常见的风险,在每种情况下都应严格评估中心静脉置管操作的适应证。静脉导管导致心脏穿孔在超过60%的病例中会导致致命后果。无穿孔的静脉导管碎片中心栓塞在大多数情况下会引发严重并发症。因此,应尝试通过经静脉技术或开胸手术取出栓塞碎片。根据我们的经验,对于经静脉取出,特殊镊子或经静脉Dotter取出套件非常有用。在两名平面X线控制下,经皮穿刺股静脉后,三名患者的中心栓塞导管碎片被抽出。