Radiologic Placement of Tunneled Central Venous Catheter

Hahn, Seong Tae; Yang, Po Song; Yang, Dong Hunn; Kim, Ki Tae; Kim, Choon Yul; Shinn, Kyung Sub; Yun, Eun Joo

Abstract

PURPOSE
To evaluate the efficacy and safety of fluoroscopy-guided, radiologic placement of a tunneled central venous catheter into the superior vena cava (SVC).
MATERIALS AND METHODS
Thirty five patients underwent tunneled central venous catheter placement to facilitate long-term chemotherapy. They included 33 leukemicpatients, one colon cancer patient, and one multiple myeloma patient. After confirming central venous patency witha injection of contrast media via the peripheral cephalic or basilic vein in the wrist joint, the subclavian veinwas punctured under fluoroscopic guidance. A 7F double lumen TPN catheter was placed into the SVC through asubcutaneous tunnel in the anterior chest wall.
RESULTS
Catheter placements were successful in all patients. The mean procedure time was 17.2 minutes, mean fluoroscopy time was 1.3 minutes, mean number of punctures was 1.4, and mean volume of injected contrast media was 43.5 cc. Only two of all leukemic patients developed mild hematomas atthe puncture site, but these soon resolved themselves. None of the patients developed pneumothorax or hemothorax.but late complications included local infection in two patients (6%) and thrombotic occlusion of the catheter inone (3%). The occluded catheter was successfully recanalized with Urokinase infusion.
CONCLUSION
Fluoroscopy-guided, radiologic placement of a tunneled central venous catheter is an easy and safe method, anduseful for patients requiring long-term venous access.