Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial

Abstract

Central venous insertion modality and sites had no impact on either early or late complication rates, but US-guided subclavian insertion showed the lowest proportion of failures.

A Comparative Study between Two Central Venous Access Techniques Performed by Junior Residents

“…Thus, exploring some evidence to select the best approach to teach initially during the early learning curve of the surgical training, we examined a cohort of patients who consecutively underwent CVA performed by junior residents from our department. Herein, the overall rates of successful CVA and morbidity did not significantly differ between the techniques and were found to be similar to those from other recent studies [3,4,[15][16][17][18], but interestingly, we found no significant impact by the resident learning curve on these outcomes. Because of an absolute statistically nonsignificant difference of 20% between rates from the first to the last quartile periods, we supposed these findings mainly resulted from our limited sample size, since this difference is probably important from a clinical point of view.…”

“…Many studies have confirmed that both landmark-guided CVA techniques are feasible and safe with similar complication rates [3,4,15], but the ultrasound-guided techniques have showed lower proportion of failures and complications rates [19,20]. Ultrasound-guided CVA is a helpful technique to gain CVAs [21] and the learning process of ultrasound-guided CVAs appears safe and feasible for training medical residents [16].…”

Totally implantable venous access port systems and risk factors for complications: A one-year prospective study in a cancer centre

“…Patient satisfaction was also greater with cephalic vein catheterisation, with regard to both the esthetic appearance of the incision scar and visibility of the catheter. The results of previous studies vary, showing either an effect [10] or no effect [5,6,11] of the vein accessed on complication rates, but the veins compared differ from one study to another.…”

“…[1,2] Although TIVAPS are generally associated with a lower long-term risk of infection compared to Hickman-type central venous catheters, [3,4] complications during their placement and long-term use are still a matter of concern. These complications, including infection, catheter fracture, thrombosis and extravasation [5,6,7], may necessitate device replacement, resulting in additional patient stress and treatment delays. Cancer patients have an intrinsically high risk of venous thrombosis, related to both the disease process itself and certain cancer treatments, [8] this risk being further increased by placement of a catheter or TIVAPS.…”

Totally Implantable Central Venous Port Catheters: Radiation Exposure as a Function of Puncture Site and Operator Experience

“…Landmark-mark based punctures of the subclavian vein in particular were associated with increased rates of pneumothorax (11,(13)(14)(15)(16)(17). In addition, infection rates were lower for ultrasound-guided approaches with the Seldinger technique (1.1-8.8%) (3,11,13,18,19) compared with surgical cut-down (0.8-16.3%) (10,(20)(21)(22)(23)(24)(25). Moreover, the radiological technique does not require general anesthesia and is cost effective (26).…”