Abstract
Occult or clinically apparent central venous thrombosis frequently complicates central venous catheter placemnt in patients requiring longโterm vascular access. Thirtyโthree patients, aged 12โ83 years, underwent duplex scanning of the internal jugular, axillary, and brachial veins prior to placement of longโterm venous access catheters. Twentyโseven patients underwent duplex scanning because of a prior history of either longโterm or shortโterm central venous access. Of 12 patients with a history of longโterm central venous access, without complications, 42% (5/12) had an abnormal duplex scan demonstrating thrombosis. Duplex scans on 15 patents having complications associated with central venous access demonstrated thrombosis of one or more of the central veins, 46% (7/15). Five patients who underwent duplex scanning without a history of a previous central venous catheter or other indication were found to have normal normal central veins. In 13 patients found to have thrombosis or obstruction by duplex scan, the surgeon was directed to successful venous access in all cases. Normal findings were very helpful in confirming that the venous system was normal in selected patients. In approximately 40% of patients with a history of venous access, catheters were found to have evidence of thrombosis of one or more of the central veins. In 13 patients found to have thrombosis or obstruction by duplex scan, the surgeon was directed to a successful site for venous access in all cases. ยฉ 1993 WileyโLiss, Inc.