Radiologically guided insertion of chronic indwelling central venous catheters

A prospective study was undertaken over a 2-year period to assess the feasibility of insertion of chronic indwelling central venous catheters (Hickman lines) under radiologic control. Over 100 patients, mainly those with hematologic disorders (malignancy), had Hickman lines inserted for long-term venous access. The lines were inserted under aseptic conditions by using a subclavicular approach in the radiology department. Prior DSA was performed to confirm patency and for initial mapping of the venous anatomy. In this paper the technique is described in detail, with emphasis on antibiotic regimen and modifications and/or refinement of equipment. The results will be discussed with special emphasis on complications, in particular, infection and thrombosis