US Guidance for Vascular Access Technical Note! Paul F. Jaques, MD Matthew A. Mauro, MD Bernadette Keefe, MD
Real-time ultrasonography (US) is frequently used to access the biliary tree, urinary system, and pleural cavity, as well as abscesses and other fluid collections, but is rarely used to access blood vessels. This article describes the clinically indicated circumstances and technical aspects of US-guided access to veins and arteries. The authors' experience suggests that appropriate use of this modality significantly simplifies vascular access difficulties, reduces procedure time and morbidity, and is cost-effective.
THE use of real-time ultrasonography (US) for access guidance into renal collecting systems, the biliary system, and abscess cavities and other fluid collections is broadly accepted and practiced by most interventional radiologists. Matalon and Silver described their freehand technique as applied to nonvascular situations (1). The usefulness of this technology for guided access to superficial vascular structures was predicted in 1987, but even today, it is not widely utilized (2). It has become routine at our institution, particularly in difficult cases. This report describes the various clinical situations in which we have found freehand and guided real-time US to provide the speediest, most reliable, and safest method of access to veins and arteries. Specific technical aspects are discussed.
Index terms: Catheters and catheterization, 9>.123 • Ultrasound (US) guidance, 9>.1298 JVIR 1992; 3:427-430
1 From the Department of Radiology, School of Medicine, CB 7510, University of North Carolina, Chapel Hill, NC 27599-7510. Received August 2, 1991; revision requested September 20; revision received October 18; accepted November 5. Address reprint requests to P.F.J.