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Does the Sapien or Vasanova truly take the place of the chest xray?

 In our dept our lead Radiologist has requested me to research the validity and/or reliability of the Sapien equipment manufactured by Bard amongst fellow nurses that actually use it. He wants to know if other Radiologists or nurses are accepting the information the Sapien gives saying it is in CAJ or are they still requesting a CXR. How often are CXR still being performed with this technology? What happens if the Sapien is dropped, is the signal still reliable? Before investing in this equipment, he wants reall data from people who use it on a daily basis, and not data from companies trying to sell their equipment. We would appreciate any information good and bad about this product.Thanks

I can not give you real

I can not give you real clinical data, but I can tell you that conversations at recent meetings along with poster and podium presentations are very favorable for both systems - Sapiens and Vasonova. The manufacturers had to submit data to the FDA to obtain clearance for these products. So check carefully on the instructions for use as to what claims each manufacturer is actually stating. These instructions have received FDA clearance while the local sales reps may sometimes go beyond those statements in their efforts to sell products. From a standards of practice point of vein, I can also tell that when the INS standards document was finalized in summer of 2010, there was no enough published evidence to state that chest xrays could be eliminated. There will always be a subset of patients that will require a chest xray. Primarily this involves cardiac patients with alterations in their p wave on the ECG tracing. We need more evidence to establish which patients are in this subset, how to identify them, etc. So for now, the standard of practice remains a chest xray. But I do believe that in general ECG produces a much more reliable tip locations in the majority of patients than a conventional chest xray. On xray, all one can determine is the general area of where the tip is located. ECG will provide information as to the tip location in relationship to the SA node and the CAJ. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861


I have no experience with Vasanova yet but I can tell you that Sapiens has worked very nicely in our clinical practice. The first patient we did sans xray was a heart lung transplant that needed Gancyclovir immediately after PICC placement. What was nice is that the patient got a TEE two weeks after placement which showed the PICC in perfect placement. It is one thing for something to work, and quite another to have a high level of confidence. In our trials every PICC that xray said was off and Sapiens said was correct...Sapiens proved to be correct on repeat film. When we realized we were using an older technology(xray) to check a newer technology we stopped getting xrays on indicated patients.

Stephen Harris RN, CRNI, VA-BC
Chief Clinical Officer
Carolina Vascular Wellness

Glenda Dennis
I have been using Vasanova

I have been using Vasanova for 9 months.  I used just ECG positioning before that so have not had to use chest x-ray for nearly 2 1/2 years.  That said, I still need to use cxr now and then for the atrial fib, pacer dependent patient or the patient with stenosed vessels.  ECG positioning is more accurate than chest x-ray and the savings in time are quite extraordinary. I have seen the Sapiens system and it is very good.  We chose Vasanova for several reasons among them being you can use the Vasanova system in the patient that is unable to lie still or must be in a very upright position and you do not have difficulty with the signal in the morbidly obese patient.  The difficult picc insertion will still be difficult but you know very early if you have malpositioned and can take measures to reposition.  I have been able to narrow the landing zone from the lower third of the SVC to the caval atrial junction.  The radiologists at our facility have not been concerned about not having to read our PICC x-rays.  I have checked subsequent cxr reports for patients in whom I have placed a picc using Vasanova and am consistently in the right position.  I am convinced that chest x-ray for picc tip verificationwill eventually go the way of the peel away metal needle for picc insertions.  This is a very exciting time to be a vascular access nurse. 

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