Complications of Hickman-Broviac catheters

Although Hickman-Broviac catheters have improved the care of patients with leukemia and patients using catheters for hyperalimentation, they are associated with a substantial morbidity. We experienced a 34 per cent complication rate. Some of these complications may be relieved with new therapy (streptokinase) and some of the intraoperative problems can be prevented by a more careful technique. We believe the cephalic vein cutdown technique remains the procedure of choice. Due to the morbidity of placement, every attempt should be made to save a catheter, as in type 1 infections. Type 2 infections should be the major indication for removal of the catheters.