Ask Dr. Z

What do you use if the doctor replaces a midline? "INTERVENTION: The collateral venous network was unable to be successfully negotiated with a wire, and the decision was made to replace the patient's midline catheter. The catheter was cut to an appropriate length of 11 cm and advanced through the peel-away sheath into the vein. The tip was fluoroscopically positioned in the left axillary vein. The catheter was able to be aspirated and flushed easily. It was secured to the skin with a StatLock. IMPRESSION: Left upper extremity venogram demonstrating stenosis at the level of the upper arm with multiple venous collaterals. Technically successful exchange of left upper extremity midline over a wire under fluoroscopic guidance."