Rapid Assessment of Vascular Exit Site and Tunneling Options (RAVESTO): A new decision tool in the management of the complex vascular access patients

In the last decade, different standardized protocols have been developed for a systematic ultrasound venous assessment before central venous catheterization: RaCeVA (Rapid Central Vein Assessment), RaPeVA (Rapid Peripheral Vein Assessment), and RaFeVA (Rapid Femoral Vein Assessment). Such protocols...

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Bibliographic Details
Published inThe journal of vascular access Vol. 24; no. 2; p. 311
Main Authors Ostroff, Matthew D, Moureau, Nancy, Pittiruti, Mauro
Format Journal Article
LanguageEnglish
Published United States 01.03.2023
Subjects
Catheterization, Central Venous
Catheters, Indwelling
Femoral Vein - diagnostic imaging
Humans
Punctures
Ultrasonography, Interventional
catheter dislodgement
central venous access
tunneling
Assessment
exit site
infection prevention
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Summary:In the last decade, different standardized protocols have been developed for a systematic ultrasound venous assessment before central venous catheterization: RaCeVA (Rapid Central Vein Assessment), RaPeVA (Rapid Peripheral Vein Assessment), and RaFeVA (Rapid Femoral Vein Assessment). Such protocols were designed to locate the ideal puncture site to minimize insertion-related complications. Recently, subcutaneous tunneling of non-cuffed central venous access devices at bedside has also grown in acceptance. The main rationale for tunneling is to relocate the exit site based on patient factors and concerns for dislodgement. The tool we describe (RAVESTO-Rapid Assessment of Vascular Exit Site and Tunneling Options) defines the different options of subcutaneous tunneling and their indications in different clinical situations in patients with complex vascular access.
ISSN:1724-6032
DOI:10.1177/11297298211034306