Central venous catheter
Central venous catheters (CVC) or lines (CVL) refer to a wide range of central venous access devices but can broadly be divided into four categories. They may be inserted by medical, surgical, anesthetic/ITU, or radiology specialists.
On this page:
Classification
- peripherally inserted central catheters (PICC)
- non-tunnelled CVCs
- e.g. used in ICU or ED for emergent or short-term (<7-10 days) access
- e.g. Vascath used for haemodialysis, apheresis, stem cell collection, etc
- tunnelled CVCs
- e.g. Hickman catheters, Groshong catheter, Broviac line, Permcath
-
implantable ports
- e.g. Port-a-Cath, Infus-a-Port
- may be located in the chest or arm (brachial)
- may be single or dual lumen
Site
Central venous catheters can be inserted into a variety of veins, most commonly including:
- internal jugular vein (see: jugular venous catheters)
- subclavian vein
- femoral vein (typically only short-term access)
- brachial, basilic or cephalic veins (for PICCs and implantable ports)
Placement
Policy varies by institution but tip placement for neck/thoracic / upper limb CVCs in the superior vena cava or at the cavo-atrial junction is generally acceptable. There is a limited differential of left paramediastinal catheter positions.
Complications
- pneumothorax
- hemothorax
- infusothorax
- arrhythmia
- infection
- mediastinal hematoma
- arterial placement
- perforation of vein needing a stent
- pinch off syndrome
- retained guidewire
- guidewire shearing and fragment embolization
- sheared fragment of catheter
- malposition of port and or tip
- azygous termination
- retained hub
- downhill esophageal varices
Related Radiopaedia articles
Chest
- imaging techniques
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chest x-ray
-
approach
- adult
- pediatric
- neonatal
-
airspace opacification
- differential diagnoses of airspace opacification
- lobar consolidation
-
atelectasis
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- morphology-based
- lobar lung collapse
- chest x-ray in the exam setting
- cardiomediastinal contour
- chest radiograph zones
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- fissures
- normal chest x-ray appearance of the diaphragm
- nipple shadow
-
lines and stripes
- anterior junction line
- posterior junction line
- right paratracheal stripe
- left paratracheal stripe
- posterior tracheal stripe/tracheo-esophageal stripe
- posterior wall of bronchus intermedius
- right paraspinal line
- left paraspinal line
- aortic-pulmonary stripe
- aortopulmonary window
- azygo-esophageal recess
- spaces
- signs
- air bronchogram
- big rib sign
- Chang sign
- Chen sign
- coin lesion
- continuous diaphragm sign
- dense hilum sign
- double contour sign
- egg-on-a-string sign
- extrapleural sign
- finger in glove sign
- flat waist sign
- Fleischner sign
- ginkgo leaf sign
- Golden S sign
- Hampton hump
- haystack sign
- hilum convergence sign
- hilum overlay sign
- Hoffman-Rigler sign
- holly leaf sign
- incomplete border sign
- juxtaphrenic peak sign
- Kirklin sign
- medial stripe sign
- melting ice cube sign
- more black sign
- Naclerio V sign
- Palla sign
- pericardial fat tag sign
- Shmoo sign
- silhouette sign
- snowman sign
- spinnaker sign
- steeple sign
- straight left heart border sign
- third mogul sign
- tram-track sign
- walking man sign
- water bottle sign
- wave sign
- Westermark sign
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approach
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chest x-ray
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bronchiectasis
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tracheal stenosis
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bronchial stenosis
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tracheal stenosis
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interstitial lung disease (ILD)
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hypersensitivity pneumonitis
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- bagassosis
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- wine maker’s lung
- woodsman’s disease
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- potato riddler’s lung
- summer-type pneumonitis
- dry rot lung
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idiopathic interstitial pneumonia (mnemonic)
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pneumoconioses
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lung cancer
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non-small-cell lung cancer
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