Cath-Finder Catheter Tracking System: a new device for positioning of central venous catheters. Early experience from implantation of brachial portal systems.

To simplify the implantation procedure of a new brachially implantable venous access system (P.A.S. Port. Pharmacia Deltec Inc., St. Paul, MN, USA), the Cath-Finder Catheter Tracking System (Pharmacia Deltec) was evaluated. The Cath-Finder senses the catheter tip position by utilizing a preconnected sensor wire (guidewire) within a catheter to detect an electromagnetic signal transmitted through the body tissue from a locator wand positioned over an appropriate external landmark. The aim of the study was to evaluate the accuracy of the Cath-Finder (compared to fluoroscopy) in determining the catheter tip position peroperatively during implantation of P.A.S. Port systems in patients with malignant diseases. The accuracy of the Cath-Finder in assessing the position of the catheter tip was registered in 16 implantation procedures. The tip positions determined with the Cath-Finder (when projected on the skin) correlated well to fluoroscopy (within 1 cm in eleven patients, 2-3 cm in four patients, and 4 cm in one patient). By using the right 3rd rib parasternally as an external landmark for the locator wand, the Cath-Finder Catheter Tracking System appears to be an alternative to fluoroscopy peroperatively for accurate placement of central venous catheters in the superior vena cava. However, a postoperative confirmatory x-ray control is recommended until further experience of the system is available.