Inferior vena cava: translumbar catheterization for central venous access.

In six patients who required long-term central venous access, translumbar catheterization of the inferior vena cava was performed seven times after the usual sites of access had become thrombosed. Four of the patients were male and two were female, and they ranged in age from 2 to 76 years. Placement of a 12-F Silastic catheter in one procedure, a 10-F catheter in three, a 9-F catheter in one, and a 7-F catheter in two was successful and uncomplicated. Of the three surviving patients, two had a functioning catheter at 1 week and 32 months, respectively; in the third patient the catheter was removed after 3 weeks, a few days after successful bowel surgery. Two patients with functioning catheters died, one of metastatic breast cancer after 12 months and the other of acquired immunodeficiency syndrome after 5 weeks. One patient twice required removal of a functioning catheter due to sepsis, the first after 3 weeks and the second after 6 weeks. These results show this technique to be safe and successful for selected patients.