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Vascular Access

Discover vascular (venous) access options*

Learn about central venous catheter, implanted port, and peripheral vascular access options for patients receiving transfusion therapy as part of sickle cell disease management.

Central venous catheter (CVC)

  • A CVC may be temporary or permanent.
  • A long, thin, hollow plastic tube called a "catheter" or "line" is placed in a central vein. A central vein is a large vein located in the neck, upper chest, or groin.
  • This kind of access requires placement by specialists.
  • Typically, this type of access is associated with automated exchange transfusion.
  • Infection and thrombosis (blood clots) are the most frequent complications with long-term use of a CVC.1

Implanted port  

  • An implanted port is a device placed under the skin into a central vein and is a more permanent solution.
  • A central vein is a large vein located in the neck, upper chest, or inner thigh.
  • This kind of access requires placement by specialists.
  • Typically, this type of access is associated with exchange transfusion.
  • Because the port is implanted completely under the skin, the risk of infection is lower than with a CVC.1
  • The device may be dislodged, requiring it to be re-implanted.

Peripheral vascular access

  • This temporary option uses a needle in one or both arms.
  • Complications are consistently less frequent and less severe than with a central venous catheter (CVC).2
  • These rare complications may include risk of infection, discomfort, thrombosis (blood clots), vein infiltration (catheter goes into or comes out of your vein), and sclerosis of the veins (hardening of the blood vessels).3
  • The clinician may use an ultrasound device to help properly place the line.
  • Peripheral access may not be an option for all patients.

Other options exist

Your clinician may determine that one of these other types of vascular access is right for you:

  • Arteriovenous (AV) fistula
  • AV graft

Side effects of automated red blood cell exchange (RBCX) may include: 
Anxiety, headache, light-headedness, digital and/or facial paresthesia (tingling sensation in the arms, hands, feet, legs, or face), fever, chills, hematoma, hyperventilation, nausea and vomiting, syncope (fainting), urticaria (hives), hypotension, allergic reactions, infection, hemolysis, thrombosis in patient and device, hypocalcemia, hypokalemia, thrombocytopenia, hypoalbuminemia, anemia, coagulopathy, fatigue, hypomagnesemia, hypogammaglobulinemia, adverse tissue reaction, device failure/disposable set failure, air embolism, blood loss/anemia, electrical shock, fluid imbalance, and inadequate separation of blood components.
 
Contraindications 
Automated RBCX may not be an option for all patients with sickle cell disease. Talk to your physician about your transfusion options. Contraindications for the use of apheresis systems are limited to those associated with the infusion of solutions and replacement fluids as required by the apheresis procedure and those associated with all types of automated apheresis systems. 
 
Reactions to blood products transfused during procedures can include: 
Hemolytic transfusion reaction, immune-mediated platelet destruction, fever, allergic reactions, anaphylaxis, transfusion-related acute lung injury (TRALI), alloimmunization, posttransfusion purpura (PTP), transfusion-associated graft-versus-host disease (TA-GVHD), circulatory overload, hypothermia, metabolic complications, and transmission of infectious diseases and bacteria.4,5 

Restricted to prescription use only. 
Operators must be familiar with the system’s operating instructions.
Procedures must be performed by qualified medical personnel.

Disclaimers and notes
*Venous access varies from patient to patient and is often determined by vascular access specialists.
  1. Crookston KP. Therapeutic Apheresis: a Physician’s Handbook. 5th ed. Bethesda, MD: AABB/ASFA; 2017.
  2. Barth D, Sanchez A, Thomsen A, et al. Peripheral vascular access for therapeutic plasma exchange: a practical approach to increased utilization and selecting the most appropriate vascular access. J Clin Apher. 2020;35(3):178-187.
  3. Barth D, Nemec RM, Cho DD, et al. The practical integration of a hybrid model of ultrasound-guided peripheral venous access in a large apheresis center. J Clin Apher. 2020; 35(4):328-334.
  4. AABB. Circular of Information for the Use of Human Blood and Blood Components. Bethesda, MD: AABB; 2017.
  5. European Directorate for the Quality of Medicines & HealthCare (EDQM). Guide to the Preparation, Use and Quality Assurance of Blood Components. 20th ed. Strasbourg, France: EDQM Council of Europe; 2020.World Health Organization (WHO). Fifty-ninth world health assembly. Sickle-cell anaemia: report by the Secretariat. https://who.int. Published April 24, 2006. Accessed June 1, 2020.
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