Difference between revisions of "Fluoroscopy of central venous catheters"

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==Technique==
 
==Technique==
 
Fibrin sheaths are usually detected by fluoroscopic catheter contrast angiography.<ref name="KnutstadHager2016">{{cite journal|last1=Knutstad|first1=K.|last2=Hager|first2=B.|last3=Hauser|first3=M.|title=Radiologic diagnosis and management of complications related to central venous access|journal=Acta Radiologica|volume=44|issue=5|year=2016|pages=508–516|issn=0284-1851|doi=10.1080/j.1600-0455.2003.00115.x}}</ref> Non-ionic contrast with a high iodine concentration (for example 300 mg/ml) is injected by hand using a 10 ml or 20 ml<ref name="KnutstadHager2016"/> syringe. A precontrast view is followed by a series of images at a small field-of-view.<ref name="KnutstadHager2016"/> It can be done at 2-4 images per second,<ref name="KnutstadHager2016"/> but also up to 15 images per second and a short exposure time of 3-4 seconds.
 
Fibrin sheaths are usually detected by fluoroscopic catheter contrast angiography.<ref name="KnutstadHager2016">{{cite journal|last1=Knutstad|first1=K.|last2=Hager|first2=B.|last3=Hauser|first3=M.|title=Radiologic diagnosis and management of complications related to central venous access|journal=Acta Radiologica|volume=44|issue=5|year=2016|pages=508–516|issn=0284-1851|doi=10.1080/j.1600-0455.2003.00115.x}}</ref> Non-ionic contrast with a high iodine concentration (for example 300 mg/ml) is injected by hand using a 10 ml or 20 ml<ref name="KnutstadHager2016"/> syringe. A precontrast view is followed by a series of images at a small field-of-view.<ref name="KnutstadHager2016"/> It can be done at 2-4 images per second,<ref name="KnutstadHager2016"/> but also up to 15 images per second and a short exposure time of 3-4 seconds.
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==Evaluation==
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In the presence of fibrin sheaths, the contrast flows backwards around the catheter.
  
 
==Report==
 
==Report==

Revision as of 10:09, 4 July 2018

Author: Mikael Häggström [notes 1]

File:Central venous catheter with a fibrin sheath.jpg
The fibrin sheath is indirectly seen in these images before and after radiocontrast infusion, as the radiocontrast collects around the catheter.

Fibrin sheaths of central venous catheters can be suspected when it is possible to infuse into it but not to aspirate.

Technique

Fibrin sheaths are usually detected by fluoroscopic catheter contrast angiography.[1] Non-ionic contrast with a high iodine concentration (for example 300 mg/ml) is injected by hand using a 10 ml or 20 ml[1] syringe. A precontrast view is followed by a series of images at a small field-of-view.[1] It can be done at 2-4 images per second,[1] but also up to 15 images per second and a short exposure time of 3-4 seconds.

Evaluation

In the presence of fibrin sheaths, the contrast flows backwards around the catheter.

Report

File:Mediastinal structures on chest X-ray, annotated.jpg
Locations of the central veins.

The report should include:

  • Position of the catheter tip in relation to the central veins
  • Presence or absence of fibrin sheath

References

  1. ↑ 1.0 1.1 1.2 1.3 Knutstad, K.; Hager, B.; Hauser, M. (2016). "Radiologic diagnosis and management of complications related to central venous access ". Acta Radiologica 44 (5): 508–516. doi:10.1080/j.1600-0455.2003.00115.x. ISSN 0284-1851. 


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