Tunneled Femoral Central Venous Catheters in Children With Cancer

Abstract

ABSTRACT. Objective. We discuss the feasibility of long-term femoral venous access by means of a cuffed subcutaneously tunneled central venous catheter (Broviac catheter) in selected pediatric cancer and stem cell transplant patients in whom access via the veins of the upper part of the torso is difficult or contraindicated and in whom alternative routes must be used.Patients and Methods. We report on our experience with 9 patients (3 of whom underwent stem cell transplantation) who received femoral Broviac catheters between December 1990 and November 1999.Results. Time in place ranged from 4 to 155 days with a median of 58 days (mean: 71.2 days). Three catheters had to be removed: 1 because of infection of the subcutaneous tunnel and 2 because of catheter obstruction. The remaining 6 catheters functioned well without problems as long as they were needed; 1 of them got accidentally dislodged while the patient was off treatment. No episodes of catheter-related septicemia, thrombosis, kinking, or drug extravasation were noted; there were no catheter-related infectious complications in the transplant patients.Conclusions. Our experience indicates that in those instances in which customary access to the superior vena cava is precluded, long-term venous access by way of the femoral vein is a feasible and safe alternative in children, even in the setting of stem cell transplantation. Pediatrics 2001;107(6). URL: http://www.pediatrics.org/cgi/content/ full/107/6/e104; femoral long-term central venous catheters, Broviac, pediatric cancer patients.

Ethanol Causes Protein Precipitation—New Safety Issues for Catheter Locking Techniques

“…[1]–[3] However, the long-term use of CVCs is fraught with complications including a high rate of infection and thrombus-related dysfunction or occlusion. [4], [5] To mitigate the impact of these complications, anticoagulative, antibiotic or antimicrobial catheter lock solutions have been used prophylactically or therapeutically to maintain the intraluminal patency of CVCs.…”

Femoral Tunneled Central Venous Catheters for Terminally Ill Patients with Cancer

“…The reported femoral catheter success rate in patients with cancer approaches 100%. [12][13][14][15] The femoral site has anatomic advantages for percutaneous catheter introduction. The femoral pulse provides an easy landmark for vein localization.…”

“…10 However, use of subcutaneous tunneling can reduce catheter-related infections. [11][12][13][14][15] We have experience using a catheter with a peel-away introducer in the femoral vein and were able to insert this catheter into the inferior vena cava easily and safely. We assessed the frequency, medical indications, intervals of femoral tunneled catheter (FTC) use, and complications in terminally ill patients with cancer.…”

Differences in the outcome of surgically placed long-term central venous catheters in neonates: neck vs groin placement

“…PICC lines in general are associated with lower incidence of significant complications during introduction and a higher rate of occlusion (7.5% to 15%) [8][9][10]. The most common complications associated with Broviac catheters are sepsis and dislodgement leading to removal [3,[11][12][13][14]. Our rate of catheter sepsis for all patients combined, 3.53 per 1000 catheter-days or 9.5%, fell well within the published rates [11,12,15].…”