TUNNELED CENTRAL VENOUS ACCESS CATHETER PLACEMENT IN THE PEDIATRIC POPULATION - COMPARISON OF RADIOLOGIC AND SURGICAL RESULTS

PURPOSE: To compare the success and infection rates of radiologic plac ement with those of surgical placement of tunneled central venous acce ss catheters (TCVACs) in infants and small children. MATERIALS AND MET HODS: In 17 pediatric patients,TCVACs were placed with vascular access under ultrasound or fluoroscopic guidance in the radiology department . In 29 other patients, TCVACs were placed with percutaneous puncture or surgical cutdown in the surgery department. RESULTS: Two(ll%) of 18 attempts at radiologic placement were unsuccessful; six (38%) of the 16 radiologically placed catheters necessitated removal because of dis lodgment, malfunction, or infection; six (38%) were electively removed ; and four (25%) still function. Eight (23%) of 35 attempts at surgica l placement were unsuccessful; 17 (63%) of the 27 surgically placed ca theters required removal because of dislodgment malfunction, or infect ion; nine (33%) were electively removed; and one (4%) still functions. CONCLUSION: The success and infection rates of radiologic placement o f TCVACs were similar to those of surgical placement. Radiologic place ment required fewer attempts and was slightly less expensive.