J Korean Soc Radiol.  2015 Jan;72(1):46-56. 10.3348/jksr.2015.72.1.46.

A Single-Center Experience of 2153 Tunneled-Cuffed Catheter Insertions Radiologically Placed via the Internal Jugular Vein: An Evaluation of Technical Success and Complication Rates Relative to Underlying Disease Conditions

• Park C
• Yim NY
• Kim YT
• Noh H
• Ki SY
• Kim JK
• Kim HO
• Chang NK

• KMID: 1823934
• DOI: http://doi.org/10.3348/jksr.2015.72.1.46

Abstract

PURPOSE
To evaluate the technical success and complication rates of tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein in patients with different types of underlying diseases.
MATERIALS AND METHODS
A total of 2153 tunneled-cuffed catheter insertions performed in 1926 patients between January 2008 and December 2012 were retrospectively reviewed. All procedures were conducted using sonography and fluoroscopy. The number of catheter maintenance days, technical success rates, and complication rates were analyzed based on radiologic and medical records.
RESULTS
A total of 204809 catheter maintenance days (mean, 95.35 days; range, 0-1710 days) were recorded. Technical success was achieved in 2148 insertions (99.77%). A total of 185 complications (8.61%, 0.903/1000 catheter days) were observed, including 22 procedure-related complications (1.02%). A total of 143 catheters (6.66%) were removed due to complications. Significant differences in complication rates were observed between patients with or without underlying hematologic diseases (11.65% vs. 7.02%, respectively; p = 0.000). Significant differences in catheter thrombosis were observed between patients in which right-sided or left-sided venous approaches were used (0.81% vs. 2.70%, respectively; p = 0.010).
CONCLUSION
The very high technical success rates and very low procedure-related complication rates indicate insertion of a tunneled-cuffed catheter radiologically placed via the internal jugular vein is safe and effective.

MeSH Terms

Catheterization
Catheters*
Central Venous Catheters
Fluoroscopy
Hematologic Diseases
Humans
Jugular Veins*
Medical Records
Radiology, Interventional
Retrospective Studies
Thrombosis
Ultrasonography

Figure

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  Fig. 1 Flow chart of study population.

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  Fig. 2 Radiographs of a 62-year-old man who had an acute kidney injury. A. Chest anteroposterior radiograph obtained after tunneled catheter placement shows the tip of the catheter located at the cavoatrial junction (arrow). B. Chest posteroanterior radiograph obtained 6 months after catheter placement. The catheter is migrated and its tip is located at the clavicle level (arrow). The catheter had been removed on that day, and re-inserted on the following day.

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  Fig. 3 Chest posteroanterior radiograph of a 50-year-old woman who had an end-stage renal disease. It shows a kink in a malfunctioning tunneled catheter (arrow).

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