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 PS106. Comparison of Complication Rates of Implantable Venous Access Devices: Percutaneous vs. Cephalic Vein Cut-Down Techniques

Farah Karipineni, Nadia Awad, Lisa Jablon, Nyali Taylor, Rashad G. Choudry
Albert Einstein Medical Center, Philadelphia, PA.

OBJECTIVES: Indwelling central venous access comprises a significant proportion of vascular surgery cases. We previously compared access techniques and found the cephalic vein cut-down approach a reasonable alternative to percutaneously placed lines. We sought to determine whether utilization of the cut-down technique with smaller catheters reduced complications.

METHODS: Three hundred seven venous access devices were placed between 2001-2007 utilizing a 6.6F catheter and the cephalic vein cut-down approach. A retrospective study was performed to review complications and operative times for this technique. We compared these cases to prior 9.6F lines placed by either cut-down or percutaneous techniques. Complications examined included pneumothorax, infection, migration, thrombosis and wound complications. Statistical analysis was performed using the student t test.

RESULTS: The overall complication rate of lines placed via a cephalic vein cut-down approach utilizing a 6.6F catheter was 3.9% (11/307), significantly lower compared to 10.8% (16/148) among the 9.6F lines placed via cut-down technique (p=0.004) and 15.3% (25/163) among lines placed by percutaneous methods (p<0.0001). Mean operative time was also significantly lower (38 minutes compared to historical data of 47 minutes, p<0.0001).

CONCLUSIONS: The cut-down approach to the cephalic vein with a 6.6 F catheter provides shorter operative time and fewer overall complications compared to both percutaneous access and cut-down techniques utilizing larger size catheters.

AUTHOR DISCLOSURES: N. Awad: Nothing to disclose; R. G. Choudry: Nothing to disclose; L. Jablon: Nothing to disclose; F. Karipineni: Nothing to disclose; N. Taylor: Nothing to disclose.
 

Comparison of complications using cephalic vein cut-down technique with 9.6F vs. 6.6F indwelling catheters


Complication
Historical Data (9.6F percutaneous, n=163)
Historical Data (9.6F cephalic vein cut-down, n=148)
Current Data (6.6 F cephalic vein cut-down, n=307)
Migration
4
6
6
Deep Vein Thrombosis
3
4
2
Wound Dehiscence
2
2
1
Wound Hematoma
0
1
1
Infection
5
0
1
Pneumothorax
2
0
0
 

 

Posted April 2013

 

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