Central Venous Access

Venous access plays a vital role in patient care and is necessary for the treatment and management of those with a wide range of illnesses. Central venous access allows for safe, long-term delivery of a variety of therapies that cannot be delivered through peripheral venous access. While the role of central venous access in modern medicine was established by surgeons and anesthesiologists, the development of percutaneous (rather than surgical) venous access, advances in ultrasound and fluoroscopic guidance, and innovative interventional techniques have led interventional radiology to become the dominant provider of more than 5 million central venous catheters each year in the United States. While in the remote past, IRs were regarded as predominately technicians, this crucial role in patient care has expanded the IR’s role to include consultant and clinician. As experts in central venous access, IRs are relied upon to determine the proper access device for each patient, to safely and reliably place these devices, and to provide long-term follow-up care to those who have a device in place. A proper understanding of the types of central venous access devices, the data supporting their placement by interventional radiologists, and their indications, complications, and techniques for placement are of utmost importance to the IR in training.