Silicone venous access devices positioned with their tips high in the superior vena cava are more likely to malfunction

Petersen, J. Moller; Delaney, Joseph H; Brakstad, Mark T; Rowbotham, Ronald K.; Bagley, Charles M.

doi:10.1016/s0002-9610(99)00124-5

Cited by 139 publications

(76 citation statements)

References 10 publications

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“…To minimize the risk of venous thrombosis, catheter occlusion, and catheter migration, we positioned the catheter tip as close as possible to the cavoatrial junction or the upper right atrium [12,16,17]. We found no evidence of an increased incidence of venous thrombosis with right-SCV compared with left-SCV catheterization.…”

Section: Discussionmentioning

confidence: 89%

Right- and Left-Subclavian Vein Port-A-Cath Systems: Comparison of Complications

Tsai

Ku²,

Chen³

et al. 2012

Eur Surg Res

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Background: Central venous access systems are frequently used for delivery of medications; however, few studies have compared surgical and postoperative complications of right versus left access via the subclavian vein (SCV). The aim of this study was to compare the surgical and postoperative complications associated with Port-A-Cath system insertion via the right and left SCV. Methods: The medical records of patients who received Port-A-Cath insertion via the SCV for parenteral chemotherapy between August 2004 and July 2008 were reviewed. The incidence of surgical and postoperative complications was compared between patients who received right- versus left-SCV Port-A-Cath insertion. Results: A total of 1,848 patients were included in the study. Right-SCV catheterization was attempted in 1,029 (55.7%) patients and was successful in 866 (84.2%). Left-SCV catheterization was attempted in 819 (44.3%) patients and was successful in 651 (79.5%). The mean length of postoperative follow-up was 417.3 ± 401.3 and 396.7 ± 379.9 days for the right- and left-SCV groups, respectively. The incidence of SCV puncture failure was significantly lower in the right-SCV group (12.3%) compared with the left-SCV group (16.8%, p = 0.006). The incidence of catheter knotting at the ipsilateral brachiocephalic vein was also significantly lower in the right-SCV group (0.0%) compared with the left-SCV group (0.5%, p = 0.038), as was the incidence of catheter occlusion (1.0% for right SCV vs. 3.5% for left SCV, p = 0.001). Conclusion: These findings suggest that the right-SCV approach is superior to the left-SCV approach for Port-A-Cath insertion.

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Section: Discussionmentioning

confidence: 89%

Right- and Left-Subclavian Vein Port-A-Cath Systems: Comparison of Complications

Tsai

Ku²,

Chen³

et al. 2012

Eur Surg Res

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“…The mean distance of the catheter tips from the right atrium was about 1.5 cm in all three groups. The tips of only four catheters (two in the heparin group and two in the vitamin C group) were located 4.5 cm above the SVC/atrial junction (a distance that puts the catheters at an increased risk of occlusion [11]). …”

Section: Resultsmentioning

confidence: 99%

Keeping central venous lines open: a prospective comparison of heparin, vitamin C and sodium chloride sealing solutions in medical patients

et al. 2002

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“…If the catheter was an incorrect length and, therefore, kinked in the subcutaneous tissue,i tm ight cause early occlusion or leakage but this is af airlys imple technical point. If thecatheter tip is placed too high in the superior vena cava, or resting againstt he vessel wall thism ay also predispose to occlusion 17 but the surgeon cannot control for that beyond the tip's position on fluoroscopy at operation.The only other technicalf actor that may explain earlyf ailure is the choice of Seldinger over open cut-down, in particular the described 'pinch-off'p henomenon witht he formert echnique and possible sequelae of catheter fracture/fragmentation, leakage and catheter migration.…”

Section: Micro-organism (N)mentioning

confidence: 99%

Totally Implantable Venous Access Devices – 20 Years' Experience of Implantation in Cystic Fibrosis Patients

Royle

Davies

Gannon

2008

annals

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Silicone venous access devices positioned with their tips high in the superior vena cava are more likely to malfunction

Cited by 139 publications

References 10 publications

Right- and Left-Subclavian Vein Port-A-Cath Systems: Comparison of Complications

Right- and Left-Subclavian Vein Port-A-Cath Systems: Comparison of Complications

Keeping central venous lines open: a prospective comparison of heparin, vitamin C and sodium chloride sealing solutions in medical patients

Totally Implantable Venous Access Devices – 20 Years' Experience of Implantation in Cystic Fibrosis Patients

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