Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Vascular and Interventional Radiology


Dr. Nancy Reid


The clinical sub-specialty of Vascular Access has become increasingly complex over the past several years. The number of access devices on the market, along with their various clinical indications can be quite overwhelming and confusing to medical providers and nursing staff. These devices are associated with sequelae that include an increase in central line-associated bloodstream infections (CLABSI), vessel damage secondary to deep venous thrombosis (DVT) and stenosis, and increased healthcare-related costs. The purpose of this article is to provide physicians and allied healthcare providers with a review of the various vascular access options available to patients, placement techniques, and the indications and contraindications associated with each option. A diagrammatic visualization of upper extremity and central venous anatomy is provided for review and clarity purposes. Clinical considerations discussed include various medical comorbidities, optimal access techniques, and appropriate catheter tip placement. The article incorporates a clinical overview to help guide clinicians toward determining the appropriate vascular access choice for their patients based on the best data and expert recommendations currently available.


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