title: [Brachial percutaneous venous access. Its usefulness in the diagnostic and interventionist catheterism of complex cardiopathies].
abstract: Venous access through the superior caval vein is mandatory to study the pulmonary arteries in patients with a Glenn anastomosis. In complex congenital heart disease, repeat catheterizations may lead to iliac vein thrombosis and superior access is needed. In order to avoid the internal jugular venous puncture, we have used puncture of the antecubital vein as an elective access.
  
  
  METHODS
  Brachial puncture was attempted in 37 patients. Mean age: 10 years (3.1-33.5). 2.45 heart surgeries and 3.6 cardiac catheterizations per patient had been previously performed in this group. 40% of patients had bilateral iliac vein thrombosis.
  
  
  METHODS
  Axillary vein external compression, venous puncture and introduction of 4-6 F sheath.
  
  
  RESULTS
  Venous access through brachial vein was achieved in 34 of 37 pts (91.8%). Diagnostic catheterization was done in all, balloon test occlusion of the pulmonary valve in 3 and pulmonary artery branch dilation in 6 pts.
  
  
  RESULTS
  2 late thrombosis of the right brachial vein (6%).
  
  
  CONCLUSIONS
  Antecubital venous puncture is an alternative and useful technique that allows easy catheterization of superior caval vein, pulmonary artery and right heart chambers. It is associated with minor complication rate, avoiding internal jugular vein puncture. Certain therapeutic procedures can be performed through such route.
authors.affiliation: Centro Silesiano de Enfermedades Cardíacas, Zabrze, Polonia. jkusa@poczta.onet.pl
authors.forename: Jacek
authors.initials: J
authors.lastname: Kusa
authors.forename: Ramón Bermúdez-Cañete
authors.initials: RB
authors.lastname: Fernández
authors.forename: Sandra Matiz
authors.initials: SM
authors.lastname: Mejía
authors.forename: Marta Hernández
authors.initials: MH
authors.lastname: de Castro
authors.forename: Ignacio Herraiz
authors.initials: IH
authors.lastname: Sarachaga
authors.forename: Fernando Rueda
authors.initials: FR
authors.lastname: Núñez
authors.forename: Jacek
authors.initials: J
authors.lastname: Bialkowski
authors.forename: José I
authors.initials: JI
authors.lastname: Díez-Balda
mesh_terms: D000293:Adolescent; D000328:Adult; D000792:Angiography / Q000009:adverse effects / Q000379:methods*; D001132:Arm / Q000098:blood supply* / Q000000981:diagnostic imaging; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011677:Punctures / Q000009:adverse effects / Q000379:methods; D015642:Radiology, Interventional / Q000379:methods; D012449:Safety