Authors: Bernhard Gebauer Ulf Martin Karl Teichgräber Michael Werk Alexander Beck HansJoachim Wagner
Publish Date: 2008/01/16
Volume: 16, Issue: 8, Pages: 897-904
Abstract
Traditionally large lumen tunneled central venous catheters have been implanted by surgeons We used a technique of sonographically guided jugular venous puncture and fluoroscopically guided catheter placement to achieve a high rate of technical success and to reduce complication ratesBetween June 2002 and December 2006 186 Patients have been referred to the Radiology Department for 211 implantations of largelumen tunneled central venous catheters Insertions were performed under maximum sterile barrier in the angio suite using combined sonographic guidance for puncture of the internal jugular vein and fluoroscopy for placement of a triple lumen 125 F catheter Hickman BARD Murray Hill NJ USACatheter implantation was technically successful in 207 of 211 cases 981 Technical failure resulted in four patients due to chronic occlusions of the superior vena cava No major complications were recorded Four 19 accidental arterial punctures occurred periinterventionally 24 114 early complications bleeding dysfunction catheter rupture and infection and ten 47 late complications infection dysfunction were recorded A clinically suspected catheter infection required catheter removal in 21 10 cases 11 of 13 noninfectious catheter complications bleeding dysfunction rupture could be treated successfully by interventionalradiological treatmentPercutaneous implantation of largelumen tunneled central venous catheters can be achieved with a high technical success rate and a low complication rate under combined sonographic and fluoroscopic guidance In cases of mechanical complications catheter rescue by interventional techniques is possible in the vast majority of cases
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