Journal of Vascular Access最新文献

{"title":"Ultrasound-guided arterial catheterization with acoustic shadowing technique: A randomized controlled trial.","authors":"Haoyang Geng, Wenping Liu, Ruizhao Lyu, Yang Bai, Rui Liu, Jianhua Wang","doi":"10.1177/11297298251338711","DOIUrl":"https://doi.org/10.1177/11297298251338711","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided dynamic needle tip positioning (DNTP) and acoustic shadowing technologies demonstrate superior efficacy to palpation in improving radial artery catheterization success rates. This study aimed to evaluate the benefits of combining DNTP with acoustic shadowing technology for patients undergoing radial artery catheterization.</p><p><strong>Method: </strong>In this randomized controlled study conducted at a single center, 152 patients requiring radial artery catheterization during anesthesia were enrolled. Participants were randomly assigned to either the ultrasound-guided acoustic shadowing combined with dynamic needle tip positioning (AS-DNTP) group or the DNTP group (1:1). All procedures were performed by experienced operators. The primary outcome was the number of needle tip retractions and directional corrections, while the secondary outcomes included the first-pass success rate, total number of attempts, ultrasound localization time, overall operating time, length of the intra-arterial catheter, needle tip position score, and overall complications.</p><p><strong>Results: </strong>The AS-DNTP group demonstrated fewer total needle tip retractions and directional corrections (2.22 ± 1.06 vs 2.84 ± 1.18, <i>p</i> = 0.001), and a higher first-pass success rate (96.10%, 74/77 cases) compared to the DNTP group (86.67%, 65/75 cases), with an absolute difference of 9.44% (95% confidence interval (CI): 0.31%-19.28%; <i>p</i> = 0.038). Additionally, the AS-DNTP group had a lower overall number of attempts (1.04 ± 0.195 vs 1.13 ± 0.342, <i>p</i> = 0.038) and a shorter ultrasound localization time (6.78 ± 2.28 s vs 7.57 ± 2.55 s, <i>p</i> = 0.045).</p><p><strong>Conclusion: </strong>AS-DNTP technology holds the potential to reduce the need for needle tip retractions and directional corrections during radial artery catheterization while increasing the first-pass success rate and decreasing the ultrasound localization time.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251338711"},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor: Juxta-anastomotic stenosis in the forearm native arteriovenous fistula: Open surgery or angioplasty? By Xu, Cai et al.","authors":"Sara Dominijanni, Giulia Marrone, Anna Mudoni, Annalisa Noce, Roberto Palumbo","doi":"10.1177/11297298251326323","DOIUrl":"https://doi.org/10.1177/11297298251326323","url":null,"abstract":"<p><p>The following is a response to the Letter to the Editor: Juxta-anastomotic stenosis in the forearm native arteriovenous fistula: Open surgery or angioplasty? By Xu, Cai et al. The letter replies to questions about the selection criteria of patients with juxta-anastomotic stenosis (JAS) and describes our protocols regarding the use of percutaneous transluminal angioplasty (PTA) balloons.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251326323"},"PeriodicalIF":1.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exit-site relocation by external splicing: A rescue therapy for damaged tunneled central venous catheter.","authors":"Luca Nardelli, Antonio Scalamogna, Anxhela Hida, Carlo Alfieri, Giuseppe Castellano","doi":"10.1177/11297298251336814","DOIUrl":"https://doi.org/10.1177/11297298251336814","url":null,"abstract":"<p><p>Effective hemodialysis (HD) depends on efficient, durable, and safe vascular access. Despite incessant efforts to reduce the use of tunneled central venous catheter (tCVC), late referrals, poor planning, improper creation of arteriovenous fistula, and lack of appropriate blood vessels are responsible for high prevalence of tCVC in the dialysis population. Specific mechanical problems, such as cracked hubs, broken clamps, leaky connectors, and bloodline rupture, can jeopardize the tCVC integrity. In case of tCVC damage at the distal part of the extracutaneous portion, most catheters are usually fixed using specific repair kits. However, when the bloodline is cracked close to the exit-site, the catheter exchange over a guide wire or the placement at a new site are considered the only viable options. However, the preservation of patient vascular assets should be prioritized, especially in patients with limited or exhausted access possibilities. Thus, in order to rescue the catheter and preserve the patient's vascular asset, we describe an innovative technique to fix tCVC bloodline perforations located in the proximity of the exit-site. The procedure consists in creating a new exit-site through the shortening of the tunnel tract. The intervention of exit-site relocation by external splicing represents an attractive option to treat unfixable tCVC damage or tunnel erosion without the need for catheter removal or exchange. This mini-invasive procedure is rapid, safe, and optimally tolerated by the patient. However, the prerequisites for this procedure are an exit site-cuff distance of at least 5 cm and the availability of an adequate repair kit. Exposition of the device along the subcutaneous tract due to chronic erosion of the tunnel can be simultaneously resolved by this intervention.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251336814"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent median artery accidentally identified during radial artery catheterization: A case report.","authors":"Shoko Nakamura, Tetsuya Uchino, Shigekiyo Matsumoto","doi":"10.1177/11297298251331994","DOIUrl":"https://doi.org/10.1177/11297298251331994","url":null,"abstract":"<p><p>Radial artery catheterization is commonly performed using the pulse palpation method. However, anatomical variations, such as the persistent median artery-an embryonic structure that may persist into adulthood-can complicate this procedure. A 47-year-old female scheduled for laparoscopic surgery required radial artery catheterization for hemodynamic monitoring. Multiple attempts to place a 22-gauge catheter in the left radial artery were unsuccessful. During the procedure, a pulsating vessel was identified on the ulnar side of the radial artery. Vascular visualization devices revealed the presence of a persistent median artery, accompanied by the median nerve. Subsequently, real-time ultrasound guidance facilitated successful radial artery catheterization. Anatomical variations, such as the persistent median artery, can complicate radial artery catheterization and are not easily identified through pulse palpation alone. The use of vascular visualization devices is recommended to identify and navigate such variations, ensuring accurate catheter placement.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251331994"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of arteriovenous fistulas created with a nitinol extravascular support in patients with advanced kidney disease.","authors":"John F Lucas, Eric Secemsky, Yang Song, Mohamad A Hussain, Dirk Hentschel, Ken J Woodside, C Keith Ozaki, Alik Farber, Ellen Dillavou","doi":"10.1177/11297298251326967","DOIUrl":"https://doi.org/10.1177/11297298251326967","url":null,"abstract":"<p><strong>Background: </strong>Use of a nitinol extravascular support implanted during AVF (arteriovenous fistula) creation has been gaining traction due to its potential to improve functional success and reduce interventions; however, comparative effectiveness data with traditional unsupported AVFs are lacking. The objective of this study was to compare outcomes of AVFs created with a vascular support device versus traditional unsupported AVFs in patients with advanced kidney disease.</p><p><strong>Methods: </strong>This was a comparative effectiveness retrospective observational cohort study conducted using data from the prospective, multi-center, single-arm VasQ US Pivotal trial (extravascular support AVF group) matched with an unsupported AVF control group developed using Medicare claims data from the same surgeons that participated in the trial. Eligible control participants were Medicare fee-for-service beneficiaries who underwent AVF creation (2017-2019). Endpoints included 6-month primary patency (primary endpoint), intervention rate, and functional success. Propensity score methods using inverse probability treatment weighting were used to examine the association between supported device use and outcomes.</p><p><strong>Results: </strong>A total of 782 unsupported AVF patients were compared to the 144 supported AVF patients from the Pivotal study. Compared with unsupported AVFs, primary patency at 180 days was superior for supported AVFs (66% vs 36% for control; OR, 3.27; 95% CI, 2.15-5.17; <i>p</i> < 0.0001). Intervention rate for supported AVFs (0.97 per patient-year; 95% CI, 0.71-1.28) was nearly half of unsupported AVFs (1.91 per patient-year; 1.58-2.07; <i>p</i> < 0.0001). Functional success for supported AVF patients was significantly greater than unsupported AVFs at 90 days (43.4% vs 26.7%, respectively; <i>p</i> = 0.005) and 180 days (72.5% vs 53.7%, respectively; <i>p</i> = 0.004).</p><p><strong>Conclusions: </strong>AVFs created with extravascular support maintained higher primary patency, improved functional success, and had less reinterventions than unsupported AVFs. More patients may begin using their AVF for dialysis sooner with a lower risk of requiring a maturation procedure if created with extravascular support.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251326967"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure variability and cardiovascular risk assessment using machine learning clustering after arteriovenous fistula creation in hemodialysis patients.","authors":"Christopher Montoya, Daniel Del Castillo Rix, Camilo Polania-Sandoval, Laisel Martinez, Adriana Dejman, Danna L Cruz, Roberto I Vazquez-Padron, Marwan Tabbara, Salman Loay, Juan C Duque","doi":"10.1177/11297298251326313","DOIUrl":"https://doi.org/10.1177/11297298251326313","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension (HTN) is highly prevalent among patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD), uncontrolled HTN as well as high blood pressure variability (BPV) can significantly impact cardiovascular health. This study aims to understand the impact of BPV in patients with ESKD following arteriovenous fistula (AVF) creation for hemodialysis, to better understand its association with age, sex, BMI, and cardiovascular risk.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 83 patients who underwent AVF creation between February 2019 and October 2020 at University of Miami Hospital. During 20 months, blood pressure measurements were collected from medical records at four different times during AVF access creation process, and BPV was quantified using machine learning clustering techniques.</p><p><strong>Results: </strong>The study identified three distinct clusters among the 83 patients with ESKD who underwent AVF creation. Cluster 1 (<i>n</i> = 28) was characterized by high blood pressure variability, with a mean systolic blood pressure standard deviation of 16.2 mmHg. This cluster exhibited a significantly higher cardiovascular risk rate of 42.9% compared to Cluster 2 (<i>n</i> = 30) and Cluster 3 (<i>n</i> = 25), which had lower variability with mean systolic blood pressure standard deviations of 10.3 and 8.7 mmHg, respectively, and cardiovascular risk rates of 16.7% and 12.0%. Age, sex, and BMI did not differ significantly across the clusters.</p><p><strong>Conclusion: </strong>This study underscores the association between blood pressure variability and the increased risk of cardiovascular events, including myocardial infraction, stroke or heart failure in patients with ESKD undergoing AVF creation. Our findings highlight the critical need for vigilant monitoring of blood pressure fluctuations in this population and demonstrate how these variations are influenced by individual demographic factors. Further research is needed to develop targeted interventions to mitigate this risk.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251326313"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral intravenous catheter related phlebitis: A point prevalence study in Iraq.","authors":"Asaid Khalid Mahmood Mahmood, Banu Cihan Erdogan","doi":"10.1177/11297298251330946","DOIUrl":"https://doi.org/10.1177/11297298251330946","url":null,"abstract":"<p><strong>Objective: </strong>This study is aimed at determining the prevalence of peripheral intravenous catheter-related phlebitis in patients with peripheral intravenous catheters.</p><p><strong>Methods: </strong>This study is a point prevalence investigation involving 335 peripheral intravenous catheters among hospitalized patients in a teaching hospital in Iraq. Data collection utilized forms that documented patient characteristics, details about the peripheral intravenous catheters, and a phlebitis scale.</p><p><strong>Results: </strong>The overall prevalence of phlebitis in the study was 64.5%, with the majority of cases classified as Grade 1. Phlebitis primarily developed on Day 1 and was most commonly observed in patients in the Emergency Department. A statistically significant relationship was found between phlebitis development and chronic diseases, with a significantly higher prevalence observed in patients diagnosed with heart failure (88.5%) compared to those with other chronic conditions (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>Although the study found a high prevalence of phlebitis, most cases were classified as Grade 1. These findings support the development of policies to enhance patient safety and contribute to improving healthcare systems and literature in Iraq.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251330946"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and accuracy of intracardiac electrocardiography-guided catheter tip positioning in totally implantable venous access device placement compared to X-ray guidance.","authors":"Jianting Zhao, Xiaofang Wu, Xiujuan Wu, Zhigang Zhu, Dongliu Miao, Qiong Wu, Yiqi Jin","doi":"10.1177/11297298251336518","DOIUrl":"https://doi.org/10.1177/11297298251336518","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the accuracy and safety of intracardiac electrocardiography (IC-ECG) in positioning catheter tips for Totally Implantable Venous Access Device (TIVAD) placement.</p><p><strong>Methods: </strong>This study conducts a retrospective analysis of patient data collected from The Affiliated Suzhou Hospital of Nanjing Medical University. Patients were categorized into two groups based on the method used for catheter tip positioning: the IC-ECG group and the X-ray group. Propensity Score Matching (PSM) is employed to balance the baseline characteristics of the two groups in a 1:2 ratio. The primary outcomes of interest are the ideal position rate of the TIVAD tip and the incidence of complications. Additionally, multivariable logistic regression analysis will be utilized to identify risk factors associated with complications. The area under the ROC curve (AUC) will be calculated to evaluate the diagnostic performance of the detection methods.</p><p><strong>Results: </strong>During the period from January 2023 to June 2024, a total of 493 adult oncology patients received TIVAD. After applying PSM, 465 patients were included in the retrospective analysis, comprising 221 males (47.5%) and 244 females (52.5%), with a mean age of 62.6 years. The ideal position rates for the catheter tips were 150 cases (96.8%) in IC-ECG group and 301 cases (97.1%) in X-ray group (<i>p</i> = 0.834). The distance from the catheter tip to the carina was measured at 1.60 ± 0.356 and 1.41 ± 0.34 vertebral body units, respectively (<i>p</i> < 0.01). The overall complication rates were comparable between the two groups. Multivariate logistic regression analysis indicated that BMI is an independent risk factor for TIVAD-related complications (OR = 0.437, 95% CI: 0.319-0.563, <i>p</i> < 0.001). The ROC curve analysis revealed that the area under the curve (AUC) for BMI was 0.926 (95% CI: 0.886-0.926, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Intracardiac electrocardiography (IC-ECG)-guided catheter tip positioning for TIVAD placement has demonstrated accuracy, feasibility, and safety. Given its potential to reduce radiation exposure, improve safety, and offer cost-effectiveness, IC-ECG presents a promising method for catheter tip positioning in TIVAD procedures. Based on these advantages, IC-ECG could be considered a preferable method in clinical practice.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251336518"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating risk factors and outcomes in rare disease of angiosarcomas in arteriovenous fistulas: A case report with review of literature.","authors":"Aman Pal, Laiba Masood, Emily Gaine, Krishna Sajeev, Vraj J Patel, Noureldien Darwish, Llewellyn Foulke, Michael Mellace, Nazia Habib, Loay Salman, Swati Mehta","doi":"10.1177/11297298251334874","DOIUrl":"https://doi.org/10.1177/11297298251334874","url":null,"abstract":"<p><p>Angiosarcomas are rare, aggressive tumors with a poor prognosis. Early detection is essential, as surgically removing localized tumors gives the best chance for a cure. While angiosarcomas predominantly occur in the head and neck region, they can arise from endothelial cells lining blood or lymphatic vessels throughout the body. This case study highlights a rare instance of angiosarcoma developing in a non-functioning arteriovenous fistula (AVF) many years post-renal transplantation. A 50-year-old male with a history of end-stage renal disease (ESRD), initially treated with hemodialysis through a left brachiocephalic AVF, underwent a deceased donor kidney transplant in 2016. In March 2023, patient developed pain and numbness in his left hand, revealing a thrombosed AVF and chronic arterial occlusions. Surgical interventions included a left brachial-brachial artery bypass and ulnar endarterectomy, but his condition deteriorated, leading to the identification of a 4.9 × 3.1 × 2.4 cm mass in the proximal ulnar shaft in January 2024. Biopsy results confirmed epithelioid angiosarcoma, which was subsequently treated with left upper extremity amputation and tumor resection. Metastatic disease was detected in the right lung, necessitating further surgical interventions. This case underscores the necessity for vigilance in monitoring AVFs in transplant patients. We further completed a comprehensive literature review, using PubMed, Cochrane, and Google Scholar, from 2000 to 2024, focused on angiosarcoma arising from AVFs to provide further insights into the rare association between AVFs and angiosarcoma.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251334874"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of paramedics to establish an in-hospital ultrasound-guided peripheral intravenous access program.","authors":"David Wasiak, Eric W Snell, Joshua B Gaither, Martin Demant, Gail Bradley, Josie Acuña","doi":"10.1177/11297298251333494","DOIUrl":"https://doi.org/10.1177/11297298251333494","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to evaluate the feasibility and effectiveness of an ultrasound-guided peripheral intravenous access program performed by paramedics in the emergency department.</p><p><strong>Methods: </strong>This was a retrospective, multicenter study. The medical director for each site was required to provide proof of completion of didactic training on the use of ultrasound to facilitate peripheral intravenous catheter placement; paramedic completion of hands-on training; and direct observation of successful cannulation. Training and requirements for credentialing were standardized among all institutions. Each institution utilized a secure data collection tool to collect data. Paramedics were required to complete a brief survey to collect quality improvement data each time an ultrasound-guided peripheral intravenous access attempt was made.</p><p><strong>Results: </strong>A total of 1368 survey responses were collected over 19 different sites. The overall success rate for ultrasound-guided PIV catheter placement was 95.72% (1297). Of those successful cannulations, 96.38% (1250) were completed on the first attempt of insertion, 3.32% (43) required two attempts, and 0.31% (4) reported requiring three attempts. Twenty-four complications following cannulation attempts were reported, with the most common being infiltration. The out-of-plane approach was most often used (83.77%, 1146), versus in-plane approach (16.23%, 222). The most frequent site of peripheral intravenous catheter placement was the forearm. (57.7%, 749), followed by the antecubital fossa, brachial and basilic vein respectively. The highest complication rate occurred at the basilic vein.</p><p><strong>Conclusion: </strong>In the face of expanding staffing shortages and a continued need for timely peripheral intravenous catheter placement, it is imperative to explore its application among paramedics. By incorporating ultrasound-guided peripheral intravenous catheter placement into their practice, paramedics may have the potential to improve the efficiency and success of catheter placements, thereby enhancing patient outcomes and streamlining workflow in the emergency department.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251333494"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}