Lisa K Jablon1, Katie R Ugolini, Nissin C Nahmias. 1. Marion Louise Saltzman Women's Center, Albert Einstein Medical Center, 5501 Old York Rd., Philadelphia, PA 19141, USA. jablonl@einstein.edu
Abstract
BACKGROUND: Central venous access devices play an integral role in providing long-term venous access. Percutaneous and cut-down techniques have been used with varying complications. METHODS: Between January 1998 and July of 2001, 358 venous access devices were placed at Albert Einstein Medical Center in Philadelphia, Pennsylvania. A retrospective study was performed to compare complications and operative times for 2 methods of catheter insertion. RESULTS: Overall complication rate was 14%. In lines successfully placed percutaneously, the complication rate was 15% (25 of 163) compared with 11% (16 of 148) in the successful cephalic cut-down group, P = .11. Complications including -- pneumothorax, late catheter transection, and bradycardia -- only occurred in percutaneously placed lines. Mean operative times were similar for both groups. COMMENTS: Use of the cut-down approach for long-term venous access may result in improved patient safety. The cut-down technique should be considered a safe initial approach for placement of venous access devices.
BACKGROUND: Central venous access devices play an integral role in providing long-term venous access. Percutaneous and cut-down techniques have been used with varying complications. METHODS: Between January 1998 and July of 2001, 358 venous access devices were placed at Albert Einstein Medical Center in Philadelphia, Pennsylvania. A retrospective study was performed to compare complications and operative times for 2 methods of catheter insertion. RESULTS: Overall complication rate was 14%. In lines successfully placed percutaneously, the complication rate was 15% (25 of 163) compared with 11% (16 of 148) in the successful cephalic cut-down group, P = .11. Complications including -- pneumothorax, late catheter transection, and bradycardia -- only occurred in percutaneously placed lines. Mean operative times were similar for both groups. COMMENTS: Use of the cut-down approach for long-term venous access may result in improved patient safety. The cut-down technique should be considered a safe initial approach for placement of venous access devices.
Authors: Giuseppe Cavallaro; Alessandro Sanguinetti; Olga Iorio; Giuseppe D'Ermo; Andrea Polistena; Nicola Avenia; Gianfranco Silecchia; Giorgio De Toma Journal: Int Surg Date: 2014 Jul-Aug
Authors: V Almasi-Sperling; S Hieber; J Lermann; O Strahl; M W Beckmann; W Lang; T A Sagban Journal: Geburtshilfe Frauenheilkd Date: 2016-01 Impact factor: 2.915