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[Long term central venous catheterization revisited]

S Palermo1, A Campolucci, F Capozza

  • 1Istituto di Anestesiologia a Rianimazione Università degli Studi, Genova.

Minerva Anestesiologica
|November 1, 1995
PubMed
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Long-term Venous Access Devices (VADs) placement is safe and effective, particularly using the Groshong catheter and right internal jugular vein access. Complications are rare, with percutaneous placement preferred by patients.

Area of Science:

  • Oncology
  • Vascular Surgery
  • Medical Devices

Background:

  • Long-term Venous Access Devices (VADs) are crucial for patients undergoing treatments like chemotherapy.
  • Understanding VAD placement techniques, catheter types, and associated risks is essential for patient care.

Purpose of the Study:

  • To analyze the experience with long-term VAD placement, focusing on techniques, catheter types, complications, and risk-benefit profiles.
  • To compare the efficacy and safety of different VAD types and venous access sites.

Main Methods:

  • Retrospective analysis of 243 VAD placements in 112 males and 131 females, primarily with leukemia or breast cancer.
  • Implantation of Leonard, Groshong, and Hickman type silicon catheters.
  • Evaluation of access via the right internal jugular vein and right subclavian vein.

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Main Results:

  • Successful VAD implantation in 98.7% of patients.
  • Groshong catheters demonstrated superior outcomes compared to Leonard and Hickman types.
  • Right internal jugular vein access showed advantages over right subclavian vein access.
  • Complications were rare, minor, and categorized by insertion, indwelling, and removal phases.
  • Percutaneous placement was better tolerated by patients than surgical placement.

Conclusions:

  • Long-term VAD placement, especially with Groshong catheters and right internal jugular vein access, offers a favorable risk-benefit profile.
  • Minimally invasive techniques and appropriate catheter selection contribute to successful VAD management.
  • Patient preference for percutaneous placement highlights the importance of technique in VAD procedures.