The saphenous system for long-term parenteral nutrition

Area of Science:

• Vascular Surgery
• Gastroenterology
• Critical Care Medicine

Background:

• Total parenteral nutrition (TPN) requires reliable venous access.
• Inferior vena cava (IVC) catheterization is a common route for long-term TPN.
• Alternative venous access methods are continually explored to minimize complications.

Observation:

• Three case reports detail the use of anterior femoral vein cutdowns for IVC catheterization.
• Catheters were advanced through the saphenous bulb, femoral, and iliac veins into the IVC.
• One catheter was used for blood products and monitoring; four were for TPN.

Findings:

• The described technique successfully placed elastomer catheters in the IVC via the greater saphenous vein tributary.
• Catheters remained in situ for up to 10 months without thrombotic or septic complications.
• The procedure was performed under local anesthesia.

Implications:

• This anterior femoral vein approach offers a viable and safe alternative for IVC catheterization in TPN.
• The technique may reduce risks associated with central venous catheterization.
• Further studies could evaluate this method in a broader patient population.