THE COMPLICATIONS OF CENTRAL VENOUS ACCESS SYSTEMS - A STUDY OF 218 PATIENTS

Objective: To evaluate the safety and usefulness of systems for obtaining central venous access. Design: Prospective open study. Setting: Clinica Universitaria de Navarra, Spain. Subjects: 218 consecutive patients who required long term venous access either for chemotherapy or for total parenteral nutrition, and who had no evidence of infection, a platelet count of over 40 x 10(9)/l, and a life expectancy of three months or more, had 234 devices inserted. Interventions: Insertion of either a silicone rubber (Port-A-Cath(R)) or a polyurethane (Implantofix(R)) catheter into the cephalic, jugular or subclavian vein, leaving the tip in the superior vena cava. Results: Between February 1985 and December 1990, 234 devices were implanted in 218 patients aged from 0.9 to 78 years. The median (range) length of time that the catheters functioned was 277 (7-1887) days. The overall incidence of complications was 0.09/100 days inserted, and the complication rates for infection and thrombosis were 0.02 and 0.03/100 days, respectively. Thirty two devices were removed because of complications, and 19 because the treatment had finished. Five of the 218 patients (2%) were lost to follow up. Conclusions: These devices have a long working life, and a low rate of complications, and are of great value to patients who require long term or cyclical intravenous treatment.