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Transhepatic Snare Placement for Translumbar Inferior Vena Cava Access 

Transhepatic Snare Placement for Translumbar Inferior Vena Cava Access
Transhepatic Snare Placement for Translumbar Inferior Vena Cava Access

Mikin V. Patel

, and Steven Zangan

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date: 19 September 2021

In patients requiring long-term chemotherapy, antibiotics, hemodialysis, or parenteral nutrition, central venous access is usually possible via catheter placement in the jugular, subclavian, or femoral veins. As these routes become complicated by thrombosis, stenosis, infection, or surgical intervention, the options for central venous catheter placement become limited, and direct puncture of the inferior vena cava (IVC) may be required. This chapter reviews the technique for placement of a catheter in the IVC via translumbar approach. Because direct access using anatomic landmarks can be challenging, initial puncture of the hepatic veins can be used to guide placement of an IVC catheter.

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