ACR Appropriateness Criteria® Central Venous Access Device and Site Selection. J Am Coll Radiol 2023 May;20(5S):S3-S19
Date
05/27/2023Pubmed ID
37236750DOI
10.1016/j.jacr.2023.02.021Scopus ID
2-s2.0-85160241677 (requires institutional sign-in at Scopus site)Abstract
The use of central venous access devices is ubiquitous in both inpatient and outpatient settings, whether for critical care, oncology, hemodialysis, parenteral nutrition, or diagnostic purposes. Radiology has a well-established role in the placement of these devices due to demonstrated benefits of radiologic placement in multiple clinical settings. A wide variety of devices are available for central venous access and optimal device selection is a common clinical challenge. Central venous access devices may be nontunneled, tunneled, or implantable. They may be centrally or peripherally inserted by way of veins in the neck, extremities, or elsewhere. Each device and access site presents specific risks that should be considered in each clinical scenario to minimize the risk of harm. The risk of infection and mechanical injury should be minimized in all patients. In hemodialysis patients, preservation of future access is an additional important consideration. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Author List
Expert Panel on Interventional Radiology, Massouh A, Kwan SW, Fidelman N, Higgins M, Abujudeh H, Charalel RA, Guimaraes MS, Gupta A, Lam A, Majdalany BS, Patel PJ, Stadtlander KS, Stillwell T, Teo EYL, Tong RT, Kapoor BSAuthor
Parag J. Patel MD, MS, FSIR Professor in the Radiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Diagnostic ImagingEvidence-Based Medicine
Extremities
Humans
Radiology
Societies, Medical
United States