BackTable Vascular & Interventional Ep. 626 Single Stick Vascular Access: Techniques & Benefits Explained with Dr. Kevin Wong
Mar 20, 2026
Dr. Kevin Wong, a pediatric interventional radiologist and IR division chief, walks through the single-stick central venous access technique. He discusses its origins, needle bending and trajectory, wire handling and measurement tricks. Practical tips cover tunneling, femoral variations, avoiding common pitfalls, and when to choose lines and equipment.
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Origins And Rationale For Single Stick Access
- Single-stick access originated at CHOP and began with femoral tunnels before being adapted to IJ to keep neck/chest incisions minimal.
- Kevin Wong emphasizes this evolution improved cleanliness (outside diaper line) and utility for trach patients.
Prep Needle And Wire Before Bending
- Use a 21G 7 cm micropuncture and preload the back end of an 0.018 wire into the needle before bending the needle into an L with the bevel facing up.
- Bend location depends on patient size; the back-end wire protects the tip if the needle is kinked.
Ultrasound Technique For Following The Curved Needle
- Stick the curved needle under the clavicle then lay it on its side and use ultrasound to find the needle dot then follow the curve as it elongates on screen.
- Float the ultrasound probe up the neck to track the needle as it comes around.