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

Objective: To evaluate the safety and usefulness of systems for obtain ing central venous access. Design: Prospective open study. Setting: Cl inica Universitaria de Navarra, Spain. Subjects: 218 consecutive patie nts who required long term venous access either for chemotherapy or fo r 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 mo nths or more, had 234 devices inserted. Interventions: Insertion of ei ther a silicone rubber (Port-A-Cath(R)) or a polyurethane (Implantofix (R)) catheter into the cephalic, jugular or subclavian vein, leaving t he tip in the superior vena cava. Results: Between February 1985 and D ecember 1990, 234 devices were implanted in 218 patients aged from 0.9 to 78 years. The median (range) length of time that the catheters fun ctioned was 277 (7-1887) days. The overall incidence of complications was 0.09/100 days inserted, and the complication rates for infection a nd thrombosis were 0.02 and 0.03/100 days, respectively. Thirty two de vices were removed because of complications, and 19 because the treatm ent 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.