title: Useful techniques for ultrasonography-guided free-hand puncture of a deep peripheral vein and catheter placement to obtain CT angiography.
abstract: OBJECTIVE
  To show useful techniques for ultrasonography-guided free-hand puncture of a deep peripheral vein and catheter placement (UGFHCP).
  
  
  METHODS
  The techniques were: favorable position of the patient's arm for puncturing the deep basilic vein, stable suspension of the transducer, and catheter lowering for advancement after successful venous puncture. During the study period, UGFHCP was performed for 75 of 263 patients who underwent coronary CTA. The patients were divided into two groups; those in the period before the development of the catheter lowering technique (n = 22, group A) and those after it (n = 53, group B). A catheter-based success rate was compared between groups A and B using Fisher's exact test.
  
  
  RESULTS
  Neither cancellation of coronary CTA examination due to venous access trouble, nor subcutaneous leakage of contrast medium was seen in any of the 263 patients. There were 20 catheter-based successes and 18 catheter-based failures in group A, and 49 catheter-based successes and 9 catheter-based failures in group B. The catheter-based success rate was higher in group B, with a statistically significant difference (p = 0.001).
  
  
  CONCLUSIONS
  UGFHCP achieved no cancellation of coronary CTA examination due to venous access trouble. The catheter lowering technique reduced the incidence of vessel perforation during catheter advancement, and increased the catheter-based success rate in UGFHCP.
authors.affiliation: Department of Radiology, Hitachi General Hospital, Jyonann 2-1-1, Hitachi, Ibaraki, 317-0077, Japan, toshiyuki.irie.rq@hitachi.com.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Irie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001132:Arm; D002406:Catheterization, Peripheral / Q000379:methods; D002408:Catheters, Indwelling; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000379:methods; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods
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