title: Ultrasound-guided central venous catheterization: A review of the relevant anatomy, technique, complications, and anatomical variations.
abstract: Central venous catheterization is a commonly used and important intervention. Despite its regular use it is still associated with a high incidence of complications especially infection and catheter tip embolization. Addition of ultrasound guidance to the technique has shown great improvement to the time and number of attempts for successful catheterization. The preference of vein depends greatly on the situation; subclavian vein is the preferred method overall but internal jugular vein is preferred in patients undergoing cardiac or thoracic surgery. This is especially true for pediatric patients in whom femoral vein catheterization is still preferred despite it carrying a higher risk than other locales. Addition of ultrasound guidance greatly reduces the incidence of arterial puncture and subsequent hematoma formation regardless of location. This is because it allows for visualization of anatomical variation prior to intervention and continual visualization of the needle during the placement. It is noteworthy however, that addition of ultrasound does not prevent complications such as catheter tip embolization as this may occur even with perfect placement. The value of ultrasound usage is undisputable since all studies assessing the difference between it and landmark based methods showed preferable outcome. Reduction of time and number of attempts is sufficient argument to make ultrasound guidance standard practice. Clin. Anat. 30:237-250, 2017. © 2017 Wiley Periodicals, Inc.
authors: Department of Anatomical Sciences, School of Medicine, St. George's University, West, Grenada Indies.
authors: Taryn
authors: T
authors: Hoffman
authors: Department of Anatomical Sciences, School of Medicine, St. George's University, West, Grenada Indies.
authors: Maira
authors: M
authors: Du Plessis
authors: Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, NV.
authors: Matthew P
authors: MP
authors: Prekupec
authors: Department of Anatomy, University of Warmia and Mazury in Olsztyn, Poland.
authors: Jerzy
authors: J
authors: Gielecki
authors: Department of Radiology, Warmia and Mazury, University Hospital, Poland.
authors: Anna
authors: A
authors: Zurada
authors: Seattle Science Foundation, Seattle, Washington.
authors: R Shane
authors: 0000-0003-1317-1047
authors: RS
authors: Tubbs
authors: Department of Anatomical Sciences, School of Medicine, St. George's University, West, Grenada Indies.
authors: Marios
authors: M
authors: Loukas
mesh_terms: D063405:Anatomic Variation; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D018084:Ultrasonography, Interventional; D014680:Veins / Q000033:anatomy & histology*
keywords: central line; central venous catheter (CVC); ultrasound