Discover the cutting-edge advancements in vascular surgery as we delve into the transformative technique of guidewire replacement of valved tunneled-cuffed silicone catheters with the latest power injectable polyurethane alternatives or ports.
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Guidewire replacement of valved tunneled-cuffed silicone catheters with power injectable polyurethane tunneled-cuffed catheters or with ports.
Benvenuti et al., J Vasc Access 2024
DOI: 10.1177/11297298231218593
The article presents a new technique for replacing silicone cuffed and valved tunneled Centrally Inserted Central venous catheters (CICCs) with power injectable polyurethane cuffed tunneled CICCs. This advancement is significant because polyurethane catheters offer superior surgical performance, including faster infusion rates due to their smaller caliber. The study, conducted at the Vascular Access Unit of ASST Spedali Civili in Brescia, Italy, involved 35 successful catheter replacements over a guidewire, excluding patients with sepsis, exit site infection, or catheter damage.
The procedure was consistent and did not result in complications such as septic, thromboembolic, or hemorrhagic events, even in patients with dysfunctional coagulation cascades. This is particularly important as it demonstrates the safety and feasibility of the technique in a broader patient population, including those with thrombocytopenia or coagulation issues.
Importance: The technique offers a safe and efficient method for catheter replacement, which is crucial for cancer patients who require long-term venous access. Contribution: It expands the options for catheter replacement without the risk of complications associated with the insertion of CICCs.