Optimal skin surface landmark for the SVC-RA junction in cancer patients requiring the implantation of permanent central venous catheters.
We compared four different skin surface landmarks, the lower margin of the right 2nd costo-sternal junction (point A); the upper margin of the right 3rd costo-sternal junction (point B); the lower margin of the right 3rd costo-sternal junction (point C); and a point 5 cm below the manubrio-sternal junction (point D), in 20 cancer patients undergoing insertion of permanent central venous catheters whose tips were placed near the superior vena cava - right atrium (SVC-RA) junction under transoesophageal echocardiography guidance. The landmark was satisfactory if it was located within 1 cm of the SVC-RA junction. Points C and D were closer to the SVC-RA junction than points A and B (p < 0.0001). However, point C had the highest incidence (C: 70%, A: 0%, B: 20%, D: 30%, p < 0.0001) of being within 1 cm of the SVC-RA junction.
Hsu
J H
JH
Department of Paediatrics, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan.
Wang
S S
SS
Lu
D V
DV
Cheng
K I
KI
Wang
C K
CK
Wu
J R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000379:methods*; D002408:Catheters, Indwelling; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D012272:Ribs / Q000033:anatomy & histology; D012867:Skin / Q000033:anatomy & histology*; D013249:Sternum / Q000033:anatomy & histology; D014683:Vena Cava, Superior / Q000033:anatomy & histology