TY - JOUR
T1 - Impact of insertion site on complications in central venous access devices
AU - Mansfield, Sara A.
AU - Staszak, Jessica
AU - Murphy, Andrew J.
AU - Talbot, Lindsay
AU - Abdelhafeez, Abdelhafeez
AU - Prajapati, Hasmukh
AU - Gold, Robert
AU - Maller, Vinod
AU - Proctor, Kimberly
AU - Davidoff, Andrew M.
AU - Williams, Regan F.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - Purpose: There is still debate over the safest route for the placement of long-term central venous access devices. The aim of this study was to review a large, single-institution experience to determine the impact of access location on peri-operative complications. Methods: The records of patients undergoing subcutaneous port (SQP) and tunneled catheter insertion over a seven-year period were reviewed. Vein cannulated (subclavian (SCV) versus internal jugular (IJ) vein), and 30-day complications were assessed. Surgical complications included pneumothorax, hemothorax, infections, arrhythmia or malpositioning requiring intervention. Results: A total of 1,309 patients were included (618 SQP, 691 tunneled catheters). The location for insertion was SCV (909, 69.4%) and IJ (400, 30.6%). There were 69 complications (5.2%) (41, 4.5% SCV, 28, 7.0% IJV) including: malpositioning/malfunctioning (SCV 13, 1.4% and IJV 14, 3.0%), pneumothorax (SCV 4, 0.4% and IJV 1, 0.3%), hemothorax (SCV 0 and IJV 1, 0.3%), arrhythmia (SCV 1, 0.1%, and IJV 0), and infection within 30 days of placement (SCV 20, 2.2% and IJ 11, 2.8%). The complication rates were not significantly different based on site (p = 0.080). Conclusion: There was no significant difference in complication rates when using the subclavian versus the internal jugular vein as the site for long-term central venous access. Level of evidence: III, retrospective comparative study.
AB - Purpose: There is still debate over the safest route for the placement of long-term central venous access devices. The aim of this study was to review a large, single-institution experience to determine the impact of access location on peri-operative complications. Methods: The records of patients undergoing subcutaneous port (SQP) and tunneled catheter insertion over a seven-year period were reviewed. Vein cannulated (subclavian (SCV) versus internal jugular (IJ) vein), and 30-day complications were assessed. Surgical complications included pneumothorax, hemothorax, infections, arrhythmia or malpositioning requiring intervention. Results: A total of 1,309 patients were included (618 SQP, 691 tunneled catheters). The location for insertion was SCV (909, 69.4%) and IJ (400, 30.6%). There were 69 complications (5.2%) (41, 4.5% SCV, 28, 7.0% IJV) including: malpositioning/malfunctioning (SCV 13, 1.4% and IJV 14, 3.0%), pneumothorax (SCV 4, 0.4% and IJV 1, 0.3%), hemothorax (SCV 0 and IJV 1, 0.3%), arrhythmia (SCV 1, 0.1%, and IJV 0), and infection within 30 days of placement (SCV 20, 2.2% and IJ 11, 2.8%). The complication rates were not significantly different based on site (p = 0.080). Conclusion: There was no significant difference in complication rates when using the subclavian versus the internal jugular vein as the site for long-term central venous access. Level of evidence: III, retrospective comparative study.
KW - Access site
KW - Central venous access devices
KW - Internal jugular vein
KW - Pediatric oncology
KW - Subclavian vein
UR - http://www.scopus.com/inward/record.url?scp=85147895247&partnerID=8YFLogxK
U2 - 10.1007/s00383-023-05399-w
DO - 10.1007/s00383-023-05399-w
M3 - Article
C2 - 36773111
AN - SCOPUS:85147895247
SN - 0179-0358
VL - 39
JO - Pediatric Surgery International
JF - Pediatric Surgery International
IS - 1
M1 - 118
ER -