Skip to main content
SpringerLink
Log in

Comparison of complications between transjugular and axillosubclavian approach for placement of tunneled, central venous catheters in patients with hematological malignancy: a prospective study

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

This study was designed to compare the incidence of mechanical, thrombotic and infective complications in transjugular (IJV) and axillosubclavian (SCV) central venous catheters (CVC) in patients with hematological malignancy. In a prospective observational trial, 131 consecutive patients were classified into two groups: Group A included those with IJV catheter insertions under sonography guidance (n=61) and group B included those with SCV insertions under venography guidance (n=70). After catheter placement, patients were prospectively acquired and recorded to obtain the following data: success rates, total catheter days, and complication episodes per 100 catheter days. All procedures were technically successful. Total catheter days were 7800 (group A) versus 8391(group B). Mechanical complications were observed in three cases from group A and 11 from group B, with an incidence rate of 0.04 per 100 catheter days versus 0.13 (P=0.043), respectively. Two symptomatic thrombotic complications were observed in group B. The number of infective complications was not significantly different between the two groups (P=0.312). There was no difference in infective complication incidence between the two groups. To minimize catheter-related mechanical and thrombotic complications, however, the IJV approach is superior to the SCV approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hickman RO, Buckner CD, Clift RA, Sander JE, Stewart P, Thomas ED (1979) A modified right atrial catheters for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 148:871–875

    Google Scholar 

  2. Cockburn JF, Eynon CA, Virji N, Jackson JE (1992) Insertion of Hickman central venous catheters by using angiographic techniques in patients with hematological disorders. Am J Roentgenol 159:121–124

    Google Scholar 

  3. Reeves AR, Seshadri R, Trerotola SO (2001) Recent trends in central venous catheter placement: a comparison of interventional radiology with other specialties. J Vasc Interv Radiol 12:1211–1214

    Google Scholar 

  4. Denny DF (1992) The role of the radiologist in long-term central vein access. Radiology 185:637–638

    Google Scholar 

  5. Schillinger F, Schillinger D, Montagnac R, Milcent T (1991) Post-catheterization vein stenosis in haemodialysis: comparative angiographic study of 50 subclavian and 50 internal jugular accesses. Nephrol Dial Transplant 6:722–724

    PubMed  Google Scholar 

  6. Trerotola SO, Johnson MS, Harris VJ, Shah H, Ambrosius WT, McKusky MA, Kraus MA (1997) Outcome of tunneled hemodialysis catheters placed via the right internal jugular vein by interventional radiologists. Radiology 203:489–495

    Google Scholar 

  7. Silberzweig JE, Mitty HA (1998) Central venous access: low internal jugular vein approach using imaging guidance. Am J Roentgenol 170:1617–1620

    Google Scholar 

  8. Macdonald S, Watt AJ, McNally D, Edwards RD, Moss JG (2000) Comparison of technical success and outcome of tunneled catheters inserted via the jugular and subclavian approaches. J Vasc Interv Radiol 11:225–231

    Google Scholar 

  9. Trerotola SO, Kuhn-Fulton J, Johnson MS, Shah H, Ambrosius WT, Kneebone PH (2000) Tunneled infusion catheters: increased incidence of symptomatic venous thrombosis after subclavian versus internal jugular venous access. Radiology 217:89–93

    Google Scholar 

  10. Lund GB, Trerotola SO, Scheel PF Jr, Savader SJ, Mitchell SE, Venbrux AC, Osterman FA (1996) Outcome of tunneled hemodiapysis catheters placed by radiologists. Radiology 198:467–472

    Google Scholar 

  11. Ulz L, Petersen FB, Ford R, Blakely W, Bennett C, Grimm M, Hickman RO (1990) A prospective study of complication in Hickman right-atrial catheters in marrow transplant patients. J Parenter Enteral Nutr 14:27–30

    Google Scholar 

  12. D’Angelo P, Uderzo C, Rizzari C, Vigano EF, Rovelli A, Gornati G, Codecasa G, Locasciulli A, Masera G (1992) Central venous catheter-related complications after bone marrow transplantation in children with hematological malignancies. Bone Marrow Transplant 9:113–117

    Google Scholar 

  13. Groeger JS, Lucas AB, Thaler HT, Friedlander-Klar H, Brown AE, Kiehn TE, Armstrong D (1993) Infectious morbidity associated with long-term use of venous access devices in patients with cancer. Ann Intern Med 119:1168–1174

    CAS  PubMed  Google Scholar 

  14. Haire WD, Lieberman RP, Lund GB, Edney JA, Kessinger A, Armitage JO (1991) Thrombotic complications of silicone rubber catheters during autologous marrow and peripheral stem cell transplantation: prospective comparison of Hickman and Groshong catheters. Bone Marrow Transplant 7:57–59

    Google Scholar 

  15. Keung YK, Watkins K, Chen SC (1994) Comparative study of infectious complications of different types of chronic central venous access devices. Cancer 73:2832–2837

    Google Scholar 

  16. Petersen FB, Clift RA, Hickman RO, Sanders JE, Meyers JD, Kelleher J, Buckner CD (1986) Hickman catheters complications in marrow transplant recipients. J Parenter Enteral Nutr 10:58–62

    Google Scholar 

  17. McGee DC, Gould MK (2003) Preventing complications of central venous catheterization. N Engl J Med 348:1123–1133

    Article  PubMed  Google Scholar 

  18. Monreal M, Lafoz E, Ruiz J, Valls R, Alastrue A (1991) Upper-extremity deep venous thrombosis and pulmonary embolism. A prospective study. Chest 99:280–283

    CAS  PubMed  Google Scholar 

  19. Pearson ML (1996) Guideline for prevention of intravascular device-related infections: an overview. The Hospital Infection Control Practices Committee. Am J Infect Control 24:262–293

    Article  Google Scholar 

  20. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM (1988) CDC definitions for nosocomial infections. Am J Infect Control 16:128–140

    CAS  PubMed  Google Scholar 

  21. O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, Masur H, McCormick RD, Mermel LA, Pearson ML, Raad II, Randolph A, Weinstein RA (2002) Guidelines for the prevention of intravascular catheter-related infections. Centers for disease control and prevention. MMWR 51:1–26

    Google Scholar 

  22. Polderman KH, Girbes AR (2002) Central venous catheter use. Part 1. Mechanical complications. Intensive Care Med 28:1–17

    Article  Google Scholar 

  23. Brown-Smith JK, Stoner MH, Barley ZA (1990) Tunneled catheter thrombosis: factors related to incidence. Oncol Nurs Forum 17:543–549

    CAS  PubMed  Google Scholar 

  24. Koksoy C, Kuzu A, Erden I, Akkaya A (1995) the risk factors in central venous catheter-related thrombosis. Aust N Z J Surg 65:796–798

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Diagnostic Radiology, The Catholic University of Korea, #62 Yoido-dong, Yongdeungpo-gu, St. Mary’s Hospital, Seoul, 150-713, South Korea

    Sang Hoon Lee & Seong Tai Hahn

Authors
  1. Sang Hoon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seong Tai Hahn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seong Tai Hahn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, S.H., Hahn, S.T. Comparison of complications between transjugular and axillosubclavian approach for placement of tunneled, central venous catheters in patients with hematological malignancy: a prospective study. Eur Radiol 15, 1100–1104 (2005). https://doi.org/10.1007/s00330-005-2641-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-005-2641-0

Keywords

Search

Navigation