A new site for venous access: superficial veins of portal collateral circulation.

In case of failure of peripheral vascular access, classical alternatives are central venous or intraosseous access. We report a new site of vascular access necessitating no specific material. A 53-year-old patient with cirrhosis-induced coagulopathy, portal hypertension, and collateral abdominal portosystemic circulation required parenteral antibiotherapy. After failure of peripheral vein catheterization, he was addressed to our resuscitation room for central venous access. To avoid the risks associated with this invasive procedure, we chose an alternative approach. After skin preparation, a 20-gauge peripheral venous catheter was inserted in a dilated subcutaneous vein of abdominal wall. To our knowledge, it is the first human report of insertion of a catheter in a superficial vein of abdominal wall. It could be an alternative approach for vascular access after failure of peripheral venipuncture in patients with portal hypertension.

Citation

Jean Turc, Laurent Gergelé, Rachid Attof, Nicolas Mottard, Michel Bérend, Jean-Stéphane David. A new site for venous access: superficial veins of portal collateral circulation. The American journal of emergency medicine. 2012 Jan;30(1):258.e1-2

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PMID: 21159464

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