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Updated: Aug 17, 2026
Femoral Arterial and Venous Catheterization for Blood Sampling, Drug Administration and Conscious Blood Pressure and Heart Rate Measurements
Published on: January 24, 2012
Percutaneous insertion of long-term venous access catheters via the external iliac vein
M N Mathur1, D W Storey, G H White
1Department of Upper Gastrointestinal Surgery and Parenteral Nutrition, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Insights
Percutaneous external iliac vein insertion offers a viable alternative for long-term venous access when standard routes fail. However, this method presents a notable risk of catheter-related sepsis.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Oncology
Background:
- Long-term venous access is crucial for treatments like chemotherapy and parenteral nutrition.
- Traditional insertion sites include internal jugular, subclavian, and cephalic veins.
- Alternative venous access routes are needed when primary sites are compromised.
Purpose of the Study:
- To evaluate the efficacy and complications of percutaneous external iliac vein insertion for long-term venous access.
- To assess the suitability of this technique when standard venous routes are unavailable.
Main Methods:
- A retrospective review of 53 prolonged venous access catheters (Hickman and port catheters) inserted via the external iliac vein in 37 patients.
- Data collected over 5.7 years, analyzing indications, complications, and catheter dwell times.
Main Results:
- Catheters were used for chemotherapy (40%), total parenteral nutrition (36%), and other indications.
- Primary reasons for using the external iliac vein included thrombosis or sepsis of other central veins.
- 51% of catheters functioned without complications; 30% became infected, with a 17% incidence of sepsis.
- One arterial puncture occurred during insertion; venous thrombosis occurred in 6%.
Conclusions:
- Percutaneous external iliac vein insertion is a valuable technique for long-term venous access when other routes are not feasible.
- The study highlights a relatively high incidence of catheter-related sepsis associated with this approach.
- Careful patient selection and monitoring are essential for optimizing outcomes.
Abstract:
Long-term venous access using Hickman catheters and implantable subcutaneous ports is a well established technique. These devices have customarily been inserted via the internal jugular, subclavian or cephalic veins. On occasions, these routes may be unavailable. This article reviews the outcome of 53 prolonged venous access catheters (39 Hickmans and 14 catheters attached to implantable ports) inserted percutaneously via the external iliac vein into 37 patients over a period of 5.7 years. The indications for insertion were chemotherapy (40%), total parenteral nutrition (36%), intravenous antibiotics (13%), poor venous access (7%) and bone marrow transplantation (4%). The main reasons for use of the external iliac vein were thrombosis of the subclavian veins or superior vena cava and subclavian central line sepsis. The only complication of insertion was one inadvertent puncture of the external iliac artery. Twenty-seven catheters (51%) remained complication free and functioning for the time for which they were required. Four catheters (7%) are still functioning in situ having been present for 1-5 years. Sixteen catheters (30%) became infected, with a 17% incidence of septicaemia. Venous thrombosis was associated with three catheters (6%). Catheters remained in situ for a median period of 30 days (range 5-569 days). The authors conclude that long-term venous access using percutaneous external iliac vein insertion is a useful technique when other routes are unavailable, but there is a relatively high incidence of catheter-related sepsis.
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