[Radiologic and clinical follow-up of central venous indwelling catheters in home parenteral nutrition]

In the course of three weeks we examined 42 patients with central indwelling venous catheters for HPN clinically and radiologically for the development of catheter-related complications. Mean patient age was 48 years. In total 47 catheters were implanted. Their mean dwelling time was 37 weeks with the total dwelling time of all catheters amounting to 1773 weeks. In 26%, obstruction of the upper venous systems was the most frequent clinical catheter related complications. However, radiographs showed thrombotic changes on the vessel walls and/or catheter tips in 51%. In the total survey, 66% of the catheters dislocated from the original application site. Overall, 30% of the catheters dislocated into a peripheral vein. The high flexibility of the silicone catheter is probably responsible for this high dislocation rate. Malposition of the catheter represents a major risk in the development of thrombosis and obstruction of the upper venous system. As the catheter is necessary for the patients' survival and the position of the catheter can be corrected after placement we think that routine chest x-rays should be done at least every four weeks.