Difficult Venous Access  (Chronic Venous Access Problems)

Venous access is necessary for the treatment of many conditions and diseases. Sometimes, either due to patient factors or prior venous access, obtaining venous access is challenging. This is called venous occlusion.

Symptoms

Chronic venous access causing venous occlusion can lead to symptoms of post-thrombotic syndrome or venous insufficiency. Common signs include dilated superficial veins, swelling, recurrent clots, easy fatigue and weakness.

Diagnosis

Venous access problems are diagnosed upon attempts at peripheral IV placement or central venous line placement. It can also be diagnosed with imaging (Ultrasound, CT or MRI), especially when the problem needs to be mapped.

Treatment

Difficult venous access requires that those attempting venous access be skilled in advanced techniques, including ultrasound guidance. If the cause of difficult venous access is from prior venous access and involves the large, central veins, recanalization can be attempted to normalize flow and reduce symptoms.