Document Detail

Alternative insertion sites for permanent central venous access devices.
MedLine Citation:
PMID:  9484928     Owner:  NLM     Status:  MEDLINE    
Permanent central venous access devices (PCVAD) are used widely in the management of chronically ill patients, particularly in neoplastic diseases. The standard approach consists of positioning the catheter in the superior vena cava (SVC) either using subclavian or internal jugular vein puncture, or cephalic or external jugular vein cut-down, with the port implanted in a subcutaneous pouch of the thoracic region. Alternative insertion sites could be used in selected cases. In our experience, consisting of 158 PCVAD, 12 cases required a different insertion site: six cases of an SVC catheter and port on the forearm using a basilic vein cut-down, and six cases of an inferior vena cava (IVC) catheter and port in the abdominal region using a great saphenous vein cut-down. Comparing standard to alternative approaches, we observed a total morbidity rate of 8.9% and 8.3%, respectively (P=NS), while the explant rate was 5.4% vs 8.3% (P=0.1). Our data show non-significant differences in morbidity and explant rates between the two groups of patients. Alternative insertion sites for the PCVAD implant seem to be a valid possibility in the management of chronically ill patients.
F A D'Angelo; G Ramacciato; P Aurello; S Lauro; A Caramitti; M Lalle; M Magri
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology     Volume:  23     ISSN:  0748-7983     ISO Abbreviation:  Eur J Surg Oncol     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-03-05     Completed Date:  1998-03-05     Revised Date:  2007-07-02    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  547-9     Citation Subset:  IM    
Istituto di I Clinica Chirurgica-S.S. Chirurgia Geriatrica, Universita' degli Studi di Roma, La Sapienza, Italia.
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MeSH Terms
Catheterization, Central Venous / adverse effects*,  methods*

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