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Clinical performance of Hickman and Portacath atrial catheters
Insights
The Portacath atrial catheter shows fewer complications, especially sepsis, compared to Hickman catheters. This totally implanted device offers significant advantages for long-term vascular access in patients.
Area of Science:
- Vascular Surgery
- Medical Devices
- Infectious Disease
Background:
- Semipermanent vascular access is crucial for patients requiring long-term intravenous therapy.
- Hickman catheters and Portacaths are commonly used central venous catheters.
- Assessing the clinical performance and complication rates of different catheter types is essential for patient care.
Purpose of the Study:
- To compare the clinical performance of Portacath atrial catheters versus Hickman catheters.
- To evaluate complication incidence, including sepsis and device removal rates.
- To determine the suitability of each catheter type for long-term vascular access.
Main Methods:
- Retrospective review of 100 sequential atrial catheter insertions.
- Categorization of catheters into Hickman (61) and Portacath (39) groups.
- Analysis of complication rates, sepsis incidence, and duration of use.
Main Results:
- Portacaths had a lower overall complication rate (46%) compared to Hickman catheters (66%).
- Sepsis incidence was significantly lower for Portacaths (3% septicaemia) versus Hickman catheters (34% local sepsis, 21% septicaemia).
- Portacaths were removed less frequently due to complications (15% vs. 33%) and had a longer mean insertion duration (24 weeks vs. 10 weeks).
Conclusions:
- Portacath atrial catheters demonstrate a lower incidence of sepsis and complications.
- The Portacath offers significant advantages for patients requiring semipermanent vascular access.
- These findings support the use of Portacaths for improved patient outcomes in haematology and oncology settings.
Abstract:
A recent advance in semipermanent vascular access has been the development of the totally implanted Portacath atrial catheter. The outcome of 100 sequential insertions of atrial catheters, 61 of which were Hickman catheters and 39 Portacaths, has been retrospectively reviewed in order to determine differences in clinical performance between these two types. The majority (90%) of the patients were from haematology or oncology wards. The incidence of complications was 66% for Hickman catheters and 46% for Portacaths. Local sepsis developed in 34% of the Hickman catheters and line-related septicaemia in 21%. The frequency of local sepsis and septicaemia following Portacath insertion was 31% and 3% respectively. Complications necessitated the removal of 33% of the Hickman catheters and 15% of Portacaths. The mean duration of insertion was 10 weeks for Hickman catheters and 24 weeks for Portacaths. It is concluded that the Portacath is less frequently complicated by sepsis and offers significant advantages for those patients in whom it is used.