Brain Neoplasm, Cerebrovascular Moyamoya Disease, Intracranial Aneurysm
Conditions
Brief summary
Seldinger technique is a minimally invasive technique in which the practitioner accesses the target vessel with a small bore needle, then dilates to the size required for the catheter. Contrarily, modified Seldinger technique(guiding sheath-over-the-needle technique) use needle that is covered with guiding sheath. Both technique is widely used in central venous catheterization, however, few researches have been investigated to compare success rate or complications of both methods.
Detailed description
The major complications of central venous catheterization through subclavian vein, are unintended arterial puncture, pneumothorax, hemothorax, malposition of catheter etc,. We assume that using modified Seldinger technique (MST), guiding sheath is easily slid over the needle, providing stable route into the vessel lumen relatively. We aimed to compare the Seldinger technique and modified Seldinger technique(MST) on success rate and complications during subclavian central venous catheterization in this prospective, randomized , controlled trials.
Interventions
PROCEDURESeldinger technique
The aimed vessel(subclavian vein) is punctured with a sharp hollow needle, syringe is detached and guidewire is advanced through the lumen of the needle, and the needle is removed. After that catheter is passed over the guidewire into the vessel.
PROCEDUREModified Seldinger technique
The aimed vessel is punctured with the needle that is covered with guiding sheath. After vessel is punctured, guiding sheath is instantly slid over the needle into the vessel. The needle is removed, guidewire is advanced through the sheath, central catheter is placed into the vessel.
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* patient scheduled for surgery under genearl anesthesia and subclavian vein central catheterization
Exclusion criteria
* Patient who does not agree to the study * Inflammation or infection on catheterization site * Contralateral diaphragmatic dysfunction * Anatomic anomalies of subclavian artery or vein/clavicle * Previous lung surgical history * Patient who has ventriculoperitoneal shunt or chemoport on same side * Patient who has pneumo/hemothorax or lung parenchymal disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Major complication rate of subclavian catheterization | intraoperative | Compare main complication rates of subclavian catheterization including pnumothorax, hemothorax, arterial puncture, malposition of cathter. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| primary success rate of subclavian catheterization | intraoperative | Check the number of attempts of needling, guidewire advance, and catheterization in both groups. |
| Total insertion time | From skin puctuation until confim the successful catheterization anticipated within 3min | Check the total insertion time from skin puncture to confirm the successful catheterization via venous aspiration though catheter lumen. |
Countries
South Korea
Contacts
Primary ContactHee Pyung Park, MD PhD
Backup ContactEugene Kim, MD
Outcome results
None listed