Implant of subcutaneous central venous access devices in outpatient surgery

Francesco A. D'Angelo, Giovanni Ramacciato, Paolo Aurello, Alessandra Caramitti, Gaetano Lanzetta, Salvatore Lauro, Matilde Magri

Research output: Contribution to journalArticle

Abstract

Today, an increasing number of subcutaneous central venous access devices are implanted on a ambulatory basis either by percutaneous vein puncture or venous cut down. The aim of the present study was to prospectively evaluate which is the most suitable implant technique for ambulatory surgery by comparing subclavian vein puncture using a Seldinger technique with cephalic vein cut-down in terms of operative morbidity, patient acceptance and health costs. Analysis of a personal series of 189 subcutaneous central venous access device insertions did not show any significant difference between the two methods, with an overall morbidity of 9.6 and 6.5% (P = ns), respectively, a greater cost of $120 for percutaneous subclavian vein puncture and a slightly more painful experience during dilatation for catheter positioning during the Seldinger manoeuvre. Furthermore, subclavian vein puncture carries the risk of major complications, such as pneumothorax, major vessel injury or nerve palsy. In conclusion, we think that venous cut-down is the ideal technique for ambulatory surgery, limiting the Seldinger technique to cases where proper catheter insertion through the cephalic vein is impossible.

Original languageEnglish
Pages (from-to)207-210
Number of pages4
JournalAmbulatory Surgery
Volume6
Issue number4
DOIs
Publication statusPublished - Oct 1998

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Keywords

  • Ambulatory surgery
  • Subcutaneous port
  • Surgical access

ASJC Scopus subject areas

  • Medicine(all)
  • Surgery

Cite this

D'Angelo, F. A., Ramacciato, G., Aurello, P., Caramitti, A., Lanzetta, G., Lauro, S., & Magri, M. (1998). Implant of subcutaneous central venous access devices in outpatient surgery. Ambulatory Surgery, 6(4), 207-210. https://doi.org/10.1016/S0966-6532(98)00009-2