静脈切開
WordNet
- of or contained in or performing the function of the veins; "venous inflammation"; "venous blood as contrasted with arterial blood"; "venous circulation"
PrepTutorEJDIC
- 静脈[血]の / 葉脈の多い
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/12 10:42:24」(JST)
[Wiki en表示]
| Venous cutdown |
| Intervention |
| ICD-9-CM |
38.94 |
| MeSH |
D016748 |
Venous cutdown is an emergency procedure in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used to get vascular access in trauma and hypovolemic shock patients when peripheral cannulation is difficult or impossible. The saphenous vein is most commonly used. This procedure has fallen out of favor with the development of safer techniques for central venous catheterization such as the Seldinger technique and the modified Seldinger technique,[1][2][3] intraosseous infusion, as well as the use of ultrasound guidance for placement of central venous catheters without using the cutdown technique.[4][5][6]
Contents
- 1 Procedure
- 2 Complications
- 3 References
- 4 External links
Procedure
The skin is cleaned, draped, and anesthetized if time allows. The greater saphenous vein is identified on the surface above the medial malleolus, a full-thickness transverse skin incision is made, and 2 cm of the vein is freed from the surrounding structures. The vessel is tied closed distally, the proximal portion is transected (venotomy) and gently dilated, and a cannula is introduced through the venotomy and secured in place with a more proximal ligature around the vein and cannula. An intravenous line is connected to the cannula to complete the procedure.
Complications
Complications of venous cutdown include cellulitis, hematoma, phlebitis, perforation of the posterior wall of the vein, venous thrombosis and nerve and arterial transection. This procedure can result in damage to the saphenous nerve due to its intimate path with the great saphenous vein, resulting in loss of cutaneous sensation in the medial leg. Over the years the venous cutdown procedure has become outdated by the introduction and recent prehospital developments of intraosseous infusion in trauma/hypovolemic shock patients.
References
- ^ Seldinger SI: Catheter replacement of the needle in percutaneous arteriography. Acta Radiol 1953; 39:368-376
- ^ McGee WT, Mallory DL: Cannulation of the internal and external jugular veins. In: Vascular Cannulation. Problems in Critical Care. Vol. 2. Venus B, Mallory DL (Eds). Philadelphia, PA, JB Lippincott, 1988, pp 217-241
- ^ Brahos GJ, Cohen MJ: Supraclavicular central venous catheterization. Techniques and experience in 250 cases. Wisc Med J 1981; 80:36-38
- ^ Teichgraber UK, Benter T, Gebel M, et al: A sonographically guided technique for central venous access. AJR Am J Roentgenol 1997; 169:731-733
- ^ Randolph AD, Cook DJ, Gonzales CA, et al: Ultrasound guidance for placement of central venous catheters: A meta-analysis of the literature. Crit Care Med 1996; 24:2053-2058
- ^ Sabba JA, Hedges JR: Ultrasonographic guidance for internal jugular vein cannulation: An educational imperative; a desirable practice alternative. Ann Emerg Med 2006; 48:548-550
- McIntosh B, Dulchavsky S (1992). "Peripheral vascular cutdown.". Crit Care Clin 8 (4): 807–18. PMID 1393752.
External links
- Healthcare science
- Medicine
- Surgery
- Vascular surgery and other vascular procedures
- ICD-9-CM V3 38–39, ICD-10-PCS 03–6
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Vascular and
Endovascular Surgery |
| Peripheral artery disease: |
- Vascular bypass
- Embolectomy/Thrombectomy
- Angioplasty with or without Stenting
- Atherectomy
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| Carotid stenosis: |
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| Venous disease |
- Ambulatory phlebectomy
- Laser surgery
- Sclerotherapy
- Vein stripping
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| Arterial and Venous Access |
- Venous cutdown
- Arteriotomy
- Phlebotomy
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| Hemodialysis Access |
- AV Fistula and Graft
- Hemodialysis/Hemofiltration
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| Portal hypertension: |
- Transjugular intrahepatic portosystemic shunt (TIPS)
- Distal splenorenal shunt procedure
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| Aortic aneurysm / dissection: |
- Endovascular aneurysm repair (EVAR)
- Open aortic surgery
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Auxiliary to
cardiac surgery |
- Cardiopulmonary bypass
- Cardioplegia
- Extracorporeal membrane oxygenation
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| Other |
- Revascularization
- Glomectomy
- First rib resection
- Seldinger technique
- Vascular snare
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| Medical imaging |
| Angiography: |
- Digital subtraction angiography
- Cerebral angiography
- Aortography
- Fluorescein angiography
- Radionuclide angiography
- Magnetic resonance angiography
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| Venography: |
- Portography
- Impedance phlebography
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| Ultrasound: |
- Intravascular ultrasound
- Carotid ultrasonography
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| Other diagnostic |
- Angioscopy
- Ankle brachial pressure index
- Tilt table test
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Index of the circulatory system
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| Description |
- Anatomy
- Arteries
- head and neck
- arms
- chest
- abdomen
- legs
- Veins
- head and neck
- arms
- chest
- abdomen and pelvis
- legs
- Development
- Cells
- Physiology
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| Disease |
- Congenital
- Neoplasms and cancer
- Lymphatic vessels
- Injury
- Vasculitis
- Other
- Symptoms and signs
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| Treatment |
- Procedures
- Drugs
- beta blockers
- channel blockers
- diuretics
- nonsympatholytic vasodilatory antihypertensives
- peripheral vasodilators
- renin–angiotensin system
- sympatholytic antihypertensives
- vasoprotectives
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UpToDate Contents
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English Journal
- Azygos continuation of the inferior vena cava during transvenous cardiac interventions.
- Cools T, Benit E.
- Acta cardiologica.Acta Cardiol.2014 Aug;69(4):456-7.
- PMID 25181924
- Is the liberal use of preoperative 3-dimensional imaging and presternotomy femoral cutdown beneficial in reoperative adult congenital heart surgery?
- Kogon BE1, Daniel W2, Fay K2, Book W3.
- The Journal of thoracic and cardiovascular surgery.J Thorac Cardiovasc Surg.2014 Jun;147(6):1799-804. doi: 10.1016/j.jtcvs.2013.07.074. Epub 2013 Sep 23.
- OBJECTIVE: Patients with congenital heart disease frequently survive into adulthood, and many of them will require repeat surgery. Often, the unique anatomy can make reoperative sternotomy and the conduct of cardiopulmonary bypass challenging. We evaluated the utility of preoperative 3-dimensional i
- PMID 24071468
- Totally implantable venous access devices: retrospective analysis of different insertion techniques and predictors of complications in 796 devices implanted in a single institution.
- Granziera E, Scarpa M1, Ciccarese A, Filip B, Cagol M, Manfredi V, Alfieri R, Celentano C, Cappellato S, Castoro C, Meroni M.
- BMC surgery.BMC Surg.2014 May 8;14:27. doi: 10.1186/1471-2482-14-27.
- BACKGROUND: The aim of this study was to assess the efficacy and safety of totally implanted vascular devices (TIVAD) using different techniques of insertion.METHODS: We performed a retrospective study using a prospective collected database of 796 consecutive oncological patients in which TIVADs wer
- PMID 24886342
Japanese Journal
- 臨床経験 皮下埋没型中心静脈カテーテル留置術のアプローチ方法
- 小児の静脈切開による中心静脈ルート確保133例の経験
- 静脈切開法を第一選択としたDDD型ペースメーカーリード挿入の試み
Related Links
- Chappell S, Vilke GM, Chan TC, Harrigan RA, Ufberg JW. Peripheral venous cutdown. J Emerg Med. 2006 Nov. 31(4):411-6. . Boon JM, van Schoor AN, Abrahams PH, Meiring JH, Welch T, Shanahan D. Central venous ...
- Venous thromboembolism (VTE) is a condition in which a blood clot (a thrombus) forms in a vein and then dislodges to travel in the blood (an embolus). A venous thrombus most commonly occurs in the deep veins of the legs or ...
★リンクテーブル★
[★]
- 英
- venous cutdown, venotomy, cut down
- 同
- カットダウン
[★]
- 関
- vein、vena