{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T21:17:06Z","timestamp":1784582226168,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ultrasound (USG) guidance is superior to blind and open cut\u2010down techniques for accurate puncture of the internal jugular vein (IJV) or subclavian vein, but it increases the cost and duration of the procedure. Here, we report our experience with the reliability and consistency of anatomic landmark\u2010guided technique for Central Venous Access Device (CVAD) insertion in a low\u2010resource setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A retrospective analysis of the prospectively maintained database of patients undergoing CVAD insertion through one of the jugular veins was performed. Central venous access was achieved using a standardized anatomic insertion landmark (apex of Sedillot\u2019s triangle). Ultrasonography (USG) and\/or fluoroscopy assistance was taken as and when required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over 12\u00a0months (October 2021 to September 2022), a total of 208 patients underwent CVAD insertion. Central venous access was successfully achieved using anatomic landmark\u2010guided technique in all but 14 patients (6.7%), in whom USG guidance or C\u2010arm was used. Eleven out of 14 patients who needed guidance for CVAD insertion had body mass index (BMI) of more than 25, one had thyromegaly while the remaining two had an arterial puncture during cannulation. CVAD insertion\u2010related complications included deep vein thrombosis (DVT) in five, extravasation of chemotherapeutic agent in one, spontaneous extrusion related to a fall in one, and persistent withdrawal\u2010related occlusion in seven patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Anatomical landmark\u2010guided technique of CVAD insertion is safe and reliable, and can reduce the need for USG\/C\u2010arm in 93% of the patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07088-0","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T13:02:20Z","timestamp":1686661340000},"page":"2562-2567","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Revisiting the Anatomical Landmark\u2010Guided Central Venous Access Device Insertion: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"47","author":[{"given":"Pallvi","family":"Kaul","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Shri Guru Ram Rai Institute of Medical and Health Sciences Patel Nagar 248001 Dehradun Uttarakhand India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajeet Ramamani","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Shri Guru Ram Rai Institute of Medical and Health Sciences Patel Nagar 248001 Dehradun Uttarakhand India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Surgery Doon Medical College Dehradun India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Shri Guru Ram Rai Institute of Medical and Health Sciences Patel Nagar 248001 Dehradun Uttarakhand India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj Kumar","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Shri Guru Ram Rai Institute of Medical and Health Sciences Patel Nagar 248001 Dehradun Uttarakhand India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2017.02.020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13244\u2010019\u20100770\u20102"},{"issue":"4","key":"e_1_2_8_4_1","first-page":"706","article-title":"Totally implanted venous and arterial access system to replace external catheters in cancer treatment","volume":"92","author":"Niederhuber 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