Clinical performance of Hickman and Portacath atrial catheters.

A recent advance in semipermanent vascular access has been the development of the totally implanted Portacath atrial catheter. The outcome of 100 sequential insertions of atrial catheters, 61 of which were Hickman catheters and 39 Portacaths, has been retrospectively reviewed in order to determine differences in clinical performance between these two types. The majority (90%) of the patients were from haematology or oncology wards. The incidence of complications was 66% for Hickman catheters and 46% for Portacaths. Local sepsis developed in 34% of the Hickman catheters and line-related septicaemia in 21%. The frequency of local sepsis and septicaemia following Portacath insertion was 31% and 3% respectively. Complications necessitated the removal of 33% of the Hickman catheters and 15% of Portacaths. The mean duration of insertion was 10 weeks for Hickman catheters and 24 weeks for Portacaths. It is concluded that the Portacath is less frequently complicated by sepsis and offers significant advantages for those patients in whom it is used.