A comparative analysis of radiological and surgical placement of central venous catheters |
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Authors: | Kieran D. McBride Ross Fisher Neil Warnock David A. Winfield Malcolm W. Reed Peter A. Gaines |
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Affiliation: | (1) Department of Radiology, Royal Hallamshire Hospital NHS Trust, Glossop Road, Sheffield, UK;(2) Department of Surgery, Royal Hallamshire Hospital NHS Trust, Glossop Road, Sheffield, UK;(3) Department of Hematology, Royal Hallamshire Hospital NHS Trust, Glossop Road, Sheffield, UK;(4) Department of Radiology, Royal Infirmary of Edinburgh NHS Trust, Lauriston Place, EH3 9YW Edinburgh, UK |
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Abstract: | Purpose To compare the differences in practice and outcome of all radiologically and surgically placed central venous catheters retrospectively over a 2-year period simultaneously, at a single institution. Methods A total of 253 Hickman catheters were inserted in 209 patients; 120 were placed radiologically in 102 patients and 133 were placed surgically in 107 patients. The indication was chemotherapy in 76% of radiological and in 47% of surgical cases; the remainder were for total parenteral nutrition and venous access. Results There were 6 (4.5%) primary surgical failures and a further 17 (13%) surgical cases requiring multiple placement attempts. Pneumothorax occurred once (0.8%) surgically and four times (3.3%) radiologically. There were no radiological primary misplacements but there were five (3.7%) surgical ones. Catheter or central vein thrombosis occurred in four (3.3%) radiological and five (3.7%) surgical cases. The rate of infection per 1000 catheter-days was 1.9 in radiologically placed catheters and 4.0 in surgically placed ones (p<0.001). Average catheter life-span was similar for the two placement methods (100±23 days). Conclusion Radiological placement is consistently more reliable than surgical placement. There are fewer placement complications and fewer catheter infections overall. |
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Keywords: | Catheters and catheterization, complications Veins, subclavian |
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