[Placing of Hickman catheters under ultrasonic guidance]

We describe a new technique using ultrasound guided puncture of the subclavian vein and fluoroscopic control of the guide wire and the catheter position. Using this technique we performed 70 catheter introductions in 54 patients at the radiological department of the University Hospital of Rotterdam. Long term administration of chemotherapy was the most frequent indication for introduction of the Hickman catheter. The puncture related complication rate was compared with the complications of the 'blind' percutaneous puncture method, as mentioned in literature. All the ultrasound guided punctures of the subclavian vein were successful and no puncture related complications, such as pneumothorax, haemothorax or arterial puncture, occurred. Since ultrasound guided puncture of the subclavian vein in combination with fluoroscopic control of the guide wire and catheter reduces the risk of complications of introduction of Hickman catheters, we consider this technique superior to other methods.