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Vascular Catheters
Cristina Fuss, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Vascular catheters and devices: Access to circulation for administration of drugs, resuscitative fluid, and nutrition; emergent venous access; obtaining blood samples; hemodialysis; and hemodynamic monitoring/support
          • Central venous catheter (CVC): Short-term drug/fluid administration; venous access
          • Peripherally inserted central catheter (PICC): Mid- and long-term central venous access
          • Tunneled central catheter
            • Long-term central venous access: Weeks-months
            • Port catheter (PC): Drug (chemotherapy), nutrition, fluid administration
            • Hemodialysis catheter (HDC): Hemodialysis, nutrition, transfusion, drug administration
          • Pulmonary artery catheter (PAC): Measurement of central venous, intracardiac, pulmonary arterial, and pulmonary capillary wedge pressures
            • Pulmonary capillary wedge pressure reflects left atrial and left ventricular end-diastolic volume
          • Intra-aortic balloon pump (IAPB)
            • Temporary mechanical hemodynamic support in patients with cardiogenic shock using counterpulsation
            • Aortic balloon inflates in diastole (↑ coronary and peripheral organ perfusion); deflates in systole (↓ afterload)
          • Impella heart pump: Transcatheter intracardiac ventricular assist device for short-term mechanical circulatory support (cardiogenic shock; left heart failure)
            • Impella RP: Right or biventricular heart failure
          • Extracorporeal membrane oxygenation (ECMO): Modified pulmonary/cardiopulmonary bypass for cardiorespiratory support in severe cardiac/respiratory failure
            • Veno-venous (VV): Primarily for gas exchange
            • Veno-arterial (VA): Gas exchange and hemodynamic support
          • CardioMEMS: Ambulatory heart failure monitoring
            • Pulmonary artery pressure and heart rate measurements
              • Daily wireless transmission of pressure readings

        IMAGING

        • General Features

          • Radiographic Findings

            • MR Findings

              • Ultrasonographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    CLINICAL ISSUES

                    • Complications

                      DIAGNOSTIC CHECKLIST

                      • Consider

                        Selected References

                        1. Ghosh S et al: Chest radiography of contemporary trans-catheter cardiovascular devices: a pictorial essay. Cardiovasc Diagn Ther. 10(6):1874-94, 2020
                        2. Sigakis CJG et al: Radiographic review of current therapeutic and monitoring devices in the chest. Radiographics. 38(4):1027-45, 2018
                        3. Brixey AG et al: Innovative cardiac devices on chest imaging: an update. J Thorac Imaging. 32(6):343-57, 2017
                        4. Raman J et al: Subclavian artery access for ambulatory balloon pump insertion. Ann Thorac Surg. 90(3):1032-4, 2010
                        5. Hunter TB et al: Medical devices of the chest. Radiographics. 24(6):1725-46, 2004
                        Related Anatomy
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                        Related Differential Diagnoses
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                        References
                        Tables

                        Tables

                        KEY FACTS

                        • Terminology

                          • Imaging

                            • Clinical Issues

                              TERMINOLOGY

                              • Definitions

                                • Vascular catheters and devices: Access to circulation for administration of drugs, resuscitative fluid, and nutrition; emergent venous access; obtaining blood samples; hemodialysis; and hemodynamic monitoring/support
                                • Central venous catheter (CVC): Short-term drug/fluid administration; venous access
                                • Peripherally inserted central catheter (PICC): Mid- and long-term central venous access
                                • Tunneled central catheter
                                  • Long-term central venous access: Weeks-months
                                  • Port catheter (PC): Drug (chemotherapy), nutrition, fluid administration
                                  • Hemodialysis catheter (HDC): Hemodialysis, nutrition, transfusion, drug administration
                                • Pulmonary artery catheter (PAC): Measurement of central venous, intracardiac, pulmonary arterial, and pulmonary capillary wedge pressures
                                  • Pulmonary capillary wedge pressure reflects left atrial and left ventricular end-diastolic volume
                                • Intra-aortic balloon pump (IAPB)
                                  • Temporary mechanical hemodynamic support in patients with cardiogenic shock using counterpulsation
                                  • Aortic balloon inflates in diastole (↑ coronary and peripheral organ perfusion); deflates in systole (↓ afterload)
                                • Impella heart pump: Transcatheter intracardiac ventricular assist device for short-term mechanical circulatory support (cardiogenic shock; left heart failure)
                                  • Impella RP: Right or biventricular heart failure
                                • Extracorporeal membrane oxygenation (ECMO): Modified pulmonary/cardiopulmonary bypass for cardiorespiratory support in severe cardiac/respiratory failure
                                  • Veno-venous (VV): Primarily for gas exchange
                                  • Veno-arterial (VA): Gas exchange and hemodynamic support
                                • CardioMEMS: Ambulatory heart failure monitoring
                                  • Pulmonary artery pressure and heart rate measurements
                                    • Daily wireless transmission of pressure readings

                              IMAGING

                              • General Features

                                • Radiographic Findings

                                  • MR Findings

                                    • Ultrasonographic Findings

                                      • Imaging Recommendations

                                        DIFFERENTIAL DIAGNOSIS

                                          CLINICAL ISSUES

                                          • Complications

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              Selected References

                                              1. Ghosh S et al: Chest radiography of contemporary trans-catheter cardiovascular devices: a pictorial essay. Cardiovasc Diagn Ther. 10(6):1874-94, 2020
                                              2. Sigakis CJG et al: Radiographic review of current therapeutic and monitoring devices in the chest. Radiographics. 38(4):1027-45, 2018
                                              3. Brixey AG et al: Innovative cardiac devices on chest imaging: an update. J Thorac Imaging. 32(6):343-57, 2017
                                              4. Raman J et al: Subclavian artery access for ambulatory balloon pump insertion. Ann Thorac Surg. 90(3):1032-4, 2010
                                              5. Hunter TB et al: Medical devices of the chest. Radiographics. 24(6):1725-46, 2004