Central Venous Access Catheter
A CVAC is a tube that is inserted beneath your skin so there is a
simple, pain-free way for doctors or nurses to give you nutrients,
or to draw your blood. When you have a CVAC, you are spared the
irritation and discomfort of repeated needle injections.
Doctors recommend CVACs for patients who regularly undergo dialysis
or chemotherapy treatments, or for patients who frequently receive
antibiotic or antifungal infusions or nutritional supplements.
More than 3.4 million CVACs are placed each year, and doctors increasingly
recommend their use. There are several types of CVACs, including
tunneled catheters (you may hear them called Hickman or Broviac catheters),
peripherally inserted central catheters (sometimes called PICC lines
or long lines), dialysis catheters and implantable ports. The physicians
of VIA are experts in the placement and management of CVACs and have
the largest experience with CVACs in Northern Kentucky.
Central Venous Access Catheter |
What are some common uses of the procedure?
People with certain diseases or medical conditions sometimes require
that tubes be placed into the body so that they can receive medications
or nutrients directly into the blood stream or gastrointestinal system,
or so blood can be drawn. Once, surgery was required to insert these
tubes, but today these procedures can be done without surgery by
an Interventional Radiologist.
Doctors Often Recommend CVACs For Patients Who Regularly Have:
- Chemotherapy treatments
- Infusions of antibiotics or other medications
- Nutritional supplements
- Hemodialysis (Interventional radiologists also open up blocked
hemodialysis grafts, using procedures such as angioplasty or thrombolytic
therapy)
Common Types Of CVACs:
- Hickman or Broviac Catheter
- PICC Line
- Dialysis Catheter
- Implantable Ports
How Do I Prepare For The Procedure?
If you already are a patient in the hospital, your nurses and doctors
will give you instructions on how to prepare for your CVAC.
If you are being admitted to the hospital on the morning of your
CVAC procedure, or if you are having your procedure done as an outpatient,
follow these instructions unless your doctor specifies otherwise:
- Eating: Do not eat solid food after midnight on the night before
your procedure. You may drink clear liquids.
- Medication: Most people can continue to take their prescribed
medication. If you are a diabetic and take insulin, ask your doctor
about modifying your insulin dose for the day of your procedure.
If you take a blood thinner such as Coumadin, you must tell your
doctor so that it can be stopped. Bring all your medications with
you.
Are There Alternatives To CVACs?
The alternative is to continue receiving medication or drawing blood
using an IV or needle each time you undergo a procedure. If your
doctor recommends a CVAC, it's with your best interest in mind.
A CVAC will make your frequent treatments more comfortable.
What will I experience during and after the
procedure?
An interventional radiologist will do the CVAC procedure. You will
receive medication to help you relax, and the area will be numbed.
A needle is inserted into the skin, creating a small tunnel. The
CVAC is then placed in the tunnel with the tip coming to rest in
a large vein.
You may feel some pressure and slight discomfort during the procedure,
but it is not very painful.
Frequently Asked Qusions about CVACs
Can I Shower After The CVAC Procedure?
Most doctors recommend that showering be avoided until the incision
heals.
How Long Will I Need To Have The CVAC?
It depends on your medical condition. A CVAC may be needed for periods
from a few weeks or months to several years. Your doctor can give
you more information.
Are There Any Risks Related To A CVAC?
Placement of a CVAC is a safe procedure. The most common complications
are infections, blockage of the CVAC and, occasionally, clotting
of the blood. All can be resolved with appropriate medical care.
How Can I Avoid Infections Related To My CVAC?
To avoid infections, follow these instructions unless your doctor
specifies otherwise:
- Keep the skin around your CVAC dry. After the incision heals
you can take showers, but cover the area with plastic wrap. Tape
the edges of the plastic wrap to your skin so that water cannot
get in. If the area does get wet, dry the skin completely after
your shower.
- Keep the skin around your CVAC clean. Clean the area every day
or every other day with a cotton swab that has been moistened with
peroxide. Always wash your hands before you clean the CVAC site.
- Keep the skin around your CVAC covered. After cleaning the skin
around the CVAC site, cover the area with a clean bandage or dressing.
Change the dressing if it gets wet.
What are the signs of CVAC infection?
Signs of an infection are redness, soreness and swelling of the skin
around the CVAC. If you notice any of these signs, even if they are
very mild, follow these instructions unless your doctor specifies
otherwise:
- Clean the skin around your CVAC more often. For example, if you
usually clean the skin and change the dressing every other day,
start cleaning the skin and changing the dressing daily. If you
usually clean the skin and change the dressing once a day, do this
twice a day.
- Apply antibiotic ointment to the skin around the CVAC each time
you clean it. If your symptoms of infection improve promptly, keep
up the extra care for one week. Then go back to your usual CVAC
care routine.
- If the symptoms continue or you have questions or concerns, call
your doctor.
Do I Always Need A Dressing On My CVAC?
It is important to keep your CVAC very clean. A dressing is usually
recommended.
How Can I Avoid Blockage Of My CVAC?
Sometimes, despite your best efforts, your CVAC can become blocked.
To reduce the risk, flush your CVAC with sterile saline once a
day. Flushing the CVAC with saline keeps the inside as clean as
possible.
How Do I Know That My CVAC Is Blocked?
A sign that your CVAC is blocked is leakage of fluid near its opening
or feeling resistance when you flush it. If you feel resistance
when flushing, do not continue and call your doctor immediately.
What Should I Do If I Think My CVAC Is Blocked Or An Infection Does
Not Clear Up With Extra Care?
Call the interventional radiologist who placed your CVAC and/or your
primary care doctor immediately. The doctor will arrange for proper
treatment of your problem. In some cases, you will need to have your
CVAC changed, and you may need antibiotic medicine. You may even
need to be admitted to the hospital.
Are
There Other Times I Should Call My Doctor About The CVAC?
Yes. Call your doctor immediately if: your CVAC becomes dislodged
or broken you have stitches and they become loose your CVAC begins
to leak there is blood in or around your CVAC flushing or injecting
medication causes pain
Will The CVAC Limit My Activity?
You will be sore for one to two weeks after your CVAC is first inserted.
This will limit your activity. After that, you should continue
to avoid any activity that causes a pulling sensation or pain around
the CVAC. To avoid unnecessary problems, the catheter that is outside
your body should be secured with tape.
What Supplies Will I Need To Take Care Of My CVAC?
Unless your doctor specifies otherwise, you will need to buy: hydrogen
peroxide cotton swabs or cotton balls gauze pads surgical tape
antibiotic ointment sterile saline syringes.
These are available at drug stores and hospital supply stores. Your
doctor will let you know if there are supplies you need that are
not on this list.
Will The CVAC Last As Long As I Need It?
Yes. Your CVAC should last as long as you need it — anywhere
from a few weeks to many years.
What Happens When I No Longer Need My CVAC?
In most situations, the CVAC will be removed. However, if you suffer
from chronic, recurring problems, your doctor may choose to leave
it in place.