Document Type : Original Article
Authors
1 Assistant Professor, Trauma Research Center, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
2 Assistant Professor, Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Introduction: Central venous stenosis and thrombosis are much more likely to occur following the insertion of a double-lumen catheter in the subclavian vein rather than the internal jugular vein. This study aimed to evaluate the knowledge and awareness of general surgeons in Fars province regarding the complications of central venous stenosis and thrombosis following the insertion of a double-lumen subclavian catheter.
Methods: This descriptive cross-sectional study was conducted among general surgeons in Fars province through a researcher-made questionnaire designed and used to assess their knowledge regarding the complications of stenosis and thrombosis following central catheter insertion in the subclavian vein.
Results: Among the participants, 63% of them used the internal jugular vein as the preferred method of inserting a double-lumen catheter, while 36% of them preferred the subclavian method. Also, 46% of the participants were sufficiently aware of the possibility of stenosis and thrombosis following insertion of a double-lumen subclavian catheter, and 47.4% assumed that the probability of thrombosis was less than 30%.
Conclusion: The results of this study indicate that a significant percentage of general surgeons in Fars province are not aware of the high risk of stenosis and thrombosis in the subclavian vein following the insertion of a double lumen catheter. Therefore, it is recommended that constant and up-to-date training sessions be held for general surgeons in selecting the appropriate vein and using ultrasound in the insertion of a double-lumen catheter.
Keywords
- Taylor RW, Palagiri AV. Central venous catheterization. Crit Care Med. 2007;35(5):1390-6.
- Lalu MM, Fayad A, Ahmed O, Bryson GL, Fergusson DA, Barron CC, et al. Ultrasound-guided subclavian vein catheterization: a systematic review and meta-analysis. Crit Care Med. 2015;43(7):1498-507
- McGee DC, Gould MKJNEjom. Preventing complications of central venous catheterization. N Engl J Med. 2003;348(12):1123-33.
- Lefrant J-Y, Muller L, De La Coussaye J-E, Prudhomme M, Ripart J, Gouzes C, et al. Risk factors of failure and immediate complication of subclavian vein catheterization in critically ill patients. Intensive Care Med. 2002;28(8):1036-41.
- Cimochowski GE, Worley E, Rutherford W, Sartain J, Blondin J, Harter HJN. Superiority of the internal jugular over the subclavian access for temporary dialysis. Nephron Clin Pract. 1990;54(2):154-61.
- Erben J, Kvasnicka J, Bastecky J, Vortel V, editors. Experience with routine use of subclavian vein cannulation in hemodialysis. Proc Eur Dial Transplant Assoc; 1969.
- Kusminsky RE. Complications of central venous catheterization. J Am Coll Surg. 2007;204(4):681-696.
- Oguzkurt L, Tercan F, Yıldırım S, Torun D. Central venous stenosis in haemodialysis patients without a previous history of catheter placement. Eur J Radiol. 2005;55(2):237-42.
- Kundu S. Central venous disease in hemodialysis patients: prevalence, etiology and treatment. J VASC ACCESS. 2010;11(1):1-7.
- Graham AS, Ozment C, Tegtmeyer K, Lai S, Braner DA. Central venous catheterization. N Engl J Med. 2007;356(21):e21.
- Barrett N, Spencer S, Mclovor J, Brown E. Subclavian stenosis: a major complication of subclavian dialysis catheters. Nephrol Dial Transplant. 1988;3(4):423-5.
- Cimochowski GE, Worley E, Rutherford W, Sartain J, Blondin J, Harter H. Superiority of the internal jugular over the subclavian access for temporary dialysis. Nephron Clin Pract. 1990;54(2):154-61.
- Schillinger F, Schillinger D, Montagnac R, Milcent T. Post-catheterization venous stenosis in hemodialysis: comparative angiographic study of 50 subclavian and 50 internal jugular accesses. Nephrologie. 1992;13(3):127.
- Vanherweghem J-L, Yassine T, Goldman M, Vandenbosch G, Delcour C, Struyven J, et al. Subclavian vein thrombosis: a frequent complication of subclavian vein cannulation for hemodialysis. Clin Nephrol. 1986;26(5):235-8.
- Haage P, Vorwerk D, Piroth W, Schuermann K, Guenther RW. Treatment of hemodialysis-related central venous stenosis or occlusion: results of primary Wallstent placement and follow-up in 50 patients. Radiology. 1999;212(1):175-80.
- Agarwal AK, Patel BM, Haddad NJ. Central vein stenosis: a nephrologist's perspective. In Seminars in dialysis 2007 Jan (Vol. 20, No. 1, pp. 53-62). Oxford, UK: Blackwell Publishing Ltd.
- Schon D, Whittman D. Interventional Nephrology and Dialysis: Managing the Complications of Long‐Term Tunneled Dialysis Catheters. InSeminars in dialysis 2003 Jul (Vol. 16, No. 4, pp. 314-322). Malden, USA: Blackwell Science Inc.
- Salgado OJ, Urdaneta B, Colmenares B, García R, Flores C. Right versus left internal jugular vein catheterization for hemodialysis: complications and impact on ipsilateral access creation. Artif Organs. 2004;28(8):728-33.
- Mickley V. Central venous catheters: many questions, few answers. Nephrol Dial Transplant. 2002;17(8):1368-73.
- Chang CJ, Ko PJ, Hsu LA, Ko YS, Ko YL, Chen CF, et al. Highly increased cell proliferation activity in the restenotic hemodialysis vascular access after percutaneous transluminal angioplasty: implication in prevention of restenosis. Am J Kidney Dis. 2004;43(1):74-84.
- Karimi-Sari H, Faraji M, Torabi SM, Asjodi G. Success rate and complications of internal jugular vein catheterization with and without ultrasonography guide. Nursing and midwifery studies. 2014;3(4):e23204-e.