Comparison of complications between transjugular and axillosubclavian approach for placement of tunneled, central venous catheters in patients with hematological malignancy: a prospective study.

This study was designed to compare the incidence of mechanical, thrombotic and infective complications in transjugular (IJV) and axillosubclavian (SCV) central venous catheters (CVC) in patients with hematological malignancy. In a prospective observational trial, 131 consecutive patients were classified into two groups: Group A included those with IJV catheter insertions under sonography guidance (n=61) and group B included those with SCV insertions under venography guidance (n=70). After catheter placement, patients were prospectively acquired and recorded to obtain the following data: success rates, total catheter days, and complication episodes per 100 catheter days. All procedures were technically successful. Total catheter days were 7800 (group A) versus 8391(group B). Mechanical complications were observed in three cases from group A and 11 from group B, with an incidence rate of 0.04 per 100 catheter days versus 0.13 (P=0.043), respectively. Two symptomatic thrombotic complications were observed in group B. The number of infective complications was not significantly different between the two groups (P=0.312). There was no difference in infective complication incidence between the two groups. To minimize catheter-related mechanical and thrombotic complications, however, the IJV approach is superior to the SCV approach.