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Central Venous Access

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Essentials of Vascular Surgery for the General Surgeon

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Abstract

Techniques for cannulating the large central veins have evolved over the last 70 years. Aubaniac first described central venous access in 1952 reporting on his 10-year experience cannulating the subclavian vein to resuscitate wounded soldiers on the battlefield (Aubaniac, Presse Med 60(68):1456, 1952). In 1973, Broviac and colleagues developed a small-diameter catheter with a Dacron cuff that was tunneled under the skin to provide long-term central access for parenteral nutrition (Broviac et al., Surg Gynecol Obstet 136(4):602–606, 1973). A hematologist named Hickman later modified the catheter to meet the needs of bone marrow transplant patients (Hickman et al., Surg Gynecol Obstet 148(6):871–875, 1979). Venous access (VA) remains one of the most basic and important components of care across all clinical settings. In the USA alone, approximately 8 % of hospitalized patients require some form of central venous access, and more than five million central venous catheters are inserted each year (Ruesch et al., Crit Care Med 30(2):454–460, 2002; Thomson et al., Anesthesiology 51(4):359–362, 1979). Dependable and safe access is important in daily practice, and understanding the types of VA available will aid in counseling patients and their families. Decisions regarding which type of VA to use should align with the needs of the patient. In this chapter, we will review the basic principles of VA including reasons for placement, types of catheters, access sites, patient preparation, insertion technique, and complications.

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Authors and Affiliations

  1. Division of Vascular Surgery, Department of Surgery, SUNY Upstate Medical University, University Hospital, 750 East Adams Street, Syracuse, NY, 13210, USA

    Kwame S. Amankwah MD, MSc, FACS

  2. Department of Surgery and Radiology, Veterans Administration Hospital Upstate Healthcare Network, Syracuse, NY, USA

    Kwame S. Amankwah MD, MSc, FACS

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  1. Kwame S. Amankwah MD, MSc, FACS
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Correspondence to Kwame S. Amankwah MD, MSc, FACS .

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Editors and Affiliations

  1. Chief, Division of Vascular Surgery and Endovascular Services, and Lead Physician, Vascular Surgery Department of Veterans Affairs Healthcare, SUNY Upstate Medical University, and Network Upstate New York at Syracuse, Syracuse, New York, USA

    Vivian Gahtan

  2. Director of Endovascular Services, Division of Vascular Surgery and Endovascular Services, and Vascular Surgeon, Department of Veterans Affairs Healthcare, SUNY Upstate Medical University, and Network Upstate New York at Syracuse, Syracuse, New York, USA

    Michael J. Costanza

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Amankwah, K.S. (2015). Central Venous Access. In: Gahtan, V., Costanza, M. (eds) Essentials of Vascular Surgery for the General Surgeon. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1326-8_17

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