Tunneled femoral central venous catheters in children with cancer

Objective. We discuss the feasibility of long-term femoral venous access by means of a cuffed subcutaneously tunneled central venous catheter (Broviac catheter) in selected pediatric cancer and stem cell transplant patients i n whom access via the veins of the upper part of the torso is difficult or contraindicated and in whom alternative routes must be used. Patients and Methods. We report on our experience with 9 patients (3 of who m underwent stem cell transplantation) who received femoral Broviac cathete rs between December 1990 and November 1999. Results. Time in place ranged from 4 to 155 days with a median of 58 days ( mean: 71.2 days). Three catheters had to be removed: 1 because of infection of the subcutaneous tunnel and 2 because of catheter obstruction. The rema ining 6 catheters functioned well without problems as long as they were nee ded; 1 of them got accidentally dislodged while the patient was off treatme nt. No episodes of catheter-related septicemia, thrombosis, kinking, or dru g extravasation were noted; there were no catheter-related infectious compl ications in the transplant patients. Conclusions. Our experience indicates that in those instances in which cust omary access to the superior vena cava is precluded, long-term venous acces s by way of the femoral vein is a feasible and safe alternative in children , even in the setting of stem cell transplantation.