{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:24:45Z","timestamp":1760955885630,"version":"3.37.3"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T00:00:00Z","timestamp":1536537600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008645","name":"Terumo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008645","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2018,9,10]]},"abstract":"<jats:p>The short-axis out-of-plane approach (SAX-OOP) is commonly used in ultrasound-guided internal jugular vein catheterization. However, this approach has a risk of posterior vein wall injuries. The authors hypothesized that a shallow angle of approach may reduce the rate of posterior wall injuries compared with the conventional steep angle approach. The present study aimed to evaluate whether a difference in the angle of approach of the needle affects the rate of posterior wall injuries. The present study was a randomized crossover-controlled trial involving 40 medical residents, conducted in the clinical training center at a hospital with a residency program. The primary outcome measure was the rate of posterior vessel wall injuries. Subjects received a didactic lecture during which the instructors taught three SAX-OOP techniques including the conventional free-hand method (procedure C), a needle navigation system (procedure N), and a shallow puncture angle using a guidance system (procedure S). Participants were trained in these approaches under supervision and each technique tested in a simulation environment. Thirty-four of 40 residents had no previous experience with central venous catheterization and were included in the final analysis. The rate of posterior vessel wall injuries in procedure S (9%) was significantly lower than using the other approaches (procedure C, 53%; procedure N, 41%). In conclusion, a shallow angle of approach using the SAX-OOP technique resulted in significantly fewer posterior vein wall injuries in central venous catheterization compared with steep angle techniques.<\/jats:p>","DOI":"10.1155\/2018\/4793174","type":"journal-article","created":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T19:30:42Z","timestamp":1536607842000},"page":"1-5","source":"Crossref","is-referenced-by-count":11,"title":["A Shallow Angle Short-Axis Out-of-Plane Approach Reduces the Rate of Posterior Wall Injuries in Central Venous Catheterization: A Simulation Study"],"prefix":"10.1155","volume":"2018","author":[{"given":"Kunitaro","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3481-2085","authenticated-orcid":true,"given":"Joho","family":"Tokumine","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan Kawarai","family":"Lefor","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Tochigi-ken, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1610-0631","authenticated-orcid":true,"given":"Akira","family":"Motoyasu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2001-869X","authenticated-orcid":true,"given":"Kumi","family":"Moriyama","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2161-4525","authenticated-orcid":true,"given":"Tomoko","family":"Yorozu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"issue":"6","key":"1","volume":"2017","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182407cd8"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a067d4"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2008.11.022"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000823"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000759"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-012-1438-y"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14650"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2013.11.080"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2014.07.062"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes381"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev399"}],"container-title":["BioMed Research International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2018\/4793174.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2018\/4793174.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2018\/4793174.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T19:30:44Z","timestamp":1536607844000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/bmri\/2018\/4793174\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,10]]},"references-count":13,"alternative-id":["4793174","4793174"],"URL":"https:\/\/doi.org\/10.1155\/2018\/4793174","relation":{},"ISSN":["2314-6133","2314-6141"],"issn-type":[{"type":"print","value":"2314-6133"},{"type":"electronic","value":"2314-6141"}],"subject":[],"published":{"date-parts":[[2018,9,10]]}}}