This procedure is reviewed by a physician with expertise in the area presented and is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic areas.

What are Vascular Access Procedures?
A vascular access procedure is designed for patients who need intravenous (IV) access for a considerable time, longer than seven to 10 days. A simple IV set-up is effective in the short term but is far from ideal when, for instance, a patient needs a course of chemotherapy, several weeks of IV antibiotic treatment, or long-term IV feeding. A vascular access catheter is a long, thin tube that is placed in a branch vein in the arm, in the neck, or just beneath the collarbone. The tube then is threaded into a major vein in the chest. In many conditions, having this type of tube inserted provides a simple and painless means of drawing blood or delivering drugs, nutrients or both. In this way the patient is spared the discomfort and stress of repeated needle sticks. These so called central catheters can remain in place for several weeks or even months.

What are some common uses of the procedure?

• A central catheter permits infusion of solutions containing medication or nutritional substances without causing the complications that may occur with an IV, such as blood clots or local tissue damage when a toxic drug leaks out of the vein. In addition, the catheter allows pressures to be monitored in large veins, which helps in assessing heart function.
• A type of access called a subcutaneous (beneath the skin) implantable port is ideal for cancer patients who require chemotherapy once every two to four weeks. The device does not interfere with daily activities and requires no special maintenance measures.
• A variety of medications, notably antibiotics, may be infused through a central venous access catheter.
• A temporary but long-term answer to malnutrition is to use a central line to provide nutritional support and supplements such as vitamins and minerals. Patients who are expected to require IV nutrition or frequent blood draws for a prolonged time can benefit from having a tunneled catheter, a more permanent type of device that causes  scar tissue to form, anchoring the catheter to patient tissues.
• A vascular access catheter may be used temporarily for hemodialysis if the usual connection between an artery and vein is obstructed by clotted blood. In this case, the catheter contains two separate passages (lumens): one that takes venous blood from the body to be cleansed in the dialysis machine, the other that returns this blood to the body through the arterial system. A catheter also is useful if kidney disease progresses rapidly and there is no time to install permanent vascular access before starting hemodialysis.
• An access catheter may serve to deliver blood transfusions.

How should I prepare for the procedure?

You will receive instructions from staff at the interventional radiologist's office at least one day before the procedure. You will have blood drawn for preprocedure testing at either the hospital or a local clinic. Staff will advise you if changes in your regular medication schedule are necessary. You may have to avoid eating or drinking anything for several hours before the procedure. Make sure that someone will be available to drive you home afterwards.