Broviac silastic catheter insertion in children: a simplified direct subclavian approach.

With the greatly expanded indications for central venous lines in children, and especially with the introduction of the Broviac silastic catheter, a new, safe, and fast method of catheter insertion has been developed. The method combines the advantages of direct major vessel approach and the use of a Broviac catheter. Originally Broviac et al. (1973) suggested insertion of the catheter by either a subclavian venipuncture or by a cephalic vein catheterization. The latter technique is commonly used, even though technical difficulties are not infrequent. Our method is based on a modified Seldinger catheter introduction employing an 8 French Peel Away Sheath Set for the adult Broviac catheter and a 5 French set for the pediatric catheter. Forty-six catheters were placed in 43 consecutive patients ranging in age from 2 mo to 21 yr. Perioperative complications were minimal and late catheter related complications few. An increase in the number of oncologic patients was observed.