Ultrasound-guided supraclavicular central venous catheterization in patients with malignant hematologic diseases

J Anesth. 2012 Oct;26(5):775-8. doi: 10.1007/s00540-012-1401-y. Epub 2012 May 1.

Abstract

We present two cases of central venous catheterization (CVC) in which an ultrasound-guided in-plane approach was used. Case 1 was a 60-year-old man with acute myelogenous leukemia in whom a right supraclavicular CVC was performed. He had pancytopenia (leukocytes 2,000/μL; erythrocytes 350 × 10(4)/μL; platelets 5.6 × 10(4)/μL), and abnormal coagulability (prothrombin time-international normalized ratio 1.35). A linear array transducer was positioned cephalad to the right clavicle and rotated 30° clockwise. The 21-gauge needle was manipulated from outside of the transducer. A CV catheter (CV legaforce EX(®); Terumo Co., Japan) was placed and stitched near the right clavicle. The patient felt no discomfort caused by the catheter. Case 2 was a 64-year-old women with malignant lymphoma whose right internal jugular vein was surrounded by abnormally enlarged lymph nodes. CVC was performed by the in-plane supraclavicular approach, avoiding puncture of the lymph node. This novel CVC technique is useful to minimize the risk of complications and patient discomfort by indwelling catheter.

Publication types

  • Case Reports

MeSH terms

  • Catheterization, Central Venous / methods*
  • Clavicle / diagnostic imaging*
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / diagnostic imaging*
  • Leukemia, Myeloid, Acute / surgery*
  • Lymphoma / diagnostic imaging*
  • Lymphoma / surgery*
  • Male
  • Middle Aged
  • Ultrasonography, Interventional / methods*