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How to prepare
vascular accessHilman Ibrahim
Div. Of Vascular and EndovascularFKUI/!"#
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$hat is Vascular %ccess &V%'
a way to get/reach the blood vesselfor
the insertion of a exible thin;
- plastic tube
- catheter, into a blood vessel
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)eripheralvenous catheter Double lumen
catheter
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Indication andContraindication
Indicationelatifcontraindication
1 !e"odialysis
# Che"otherapy
$ %utrition
& 'luid ad"inistration
( )rugs ad"inistration
* +lood transfusion
ntiviral therapy
. ain 0"ergency Case "anage"ent
ngiology
2 Coagulopathy
2 llergy to the catheter"aterial
2 3ediastinal tu"or
2 45in infection ati"plantation site
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Vascular access can throu*h
Intra arterial
Intra venous6
- perifer a si"ple intravenous 7iv8
- central peripherally inserted central
catheter
central venous catheter 7cvc8
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Intra %rterial
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ortic neurys"
09:
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+u*ular vein
!ubclavia vein ,rachial vein
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is-s/,enets of "V")lacement
Indications for centralvenous catheter 7C9C8Inadeuate peripheral
vascular access
%eed for freuent vascularaccess
!ypertonic/hyperos"olar
infusions
Infusion of irritating orvesicant drugs
:apid absorption andblood/tissue perfusion
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imin* V.% 0
0"ergency 6 life saving
=e"porery 6
er"anent 6 !) access+lood strea" over a period, either days
or wee5s to years
i9 Catheter
)ouble lu"en Catheter !)
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he t1pes of V% "atheters
astandard intravenous 7iv8 lineaperipherally inserted central catheter 7ICC
anon tunneled catheter with a cu>
aport catheter or subcutaneous i"plantable
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Duration0
1 I9 erifer less than wee5
2. Non Tunnelled CVC( ? days3. Peripherally Inserted CVC (PICC)"ore than
wee5s-"onth
4. Skin tunnelled CVC"ore than * "onth
5. Subutanoues portost e!eti"e"ore than
"onth @ Totally i#plantable
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2on tunneled "V" !-in tunneled"V"
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!ubcutaneous port
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Vena "ava Filter
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How should V% prepare (
Indication=i"e6
A4B )oppler 6
+lood Clot 7bt,ct8
-ray 7uoroscopy8
C-r"
!hort term/da1
3on* term/wee-s4 month/1ears
#appin*/anatom1
%ssess the vein
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How is the procedure performed (
eripher 7iv line8
Central catether 6 - Dugular vein
- subclavia
- fe"oral- brachial
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re EperativeEperative
ost Eperative
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atient
na"nesis/!istory- Co"orbid/Anderlying )isease
-)3
- rterioscleorosis- !eart 'ailure
- =rau"a F unctureG / C)