Percutaneous insertion of long‐term venous access catheters via the external iliac vein

Manu N. Mathur*, David W. Storey, Geoffrey H. White, George Ramsey‐Stewart

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    19 Citations (Scopus)

    Abstract

    Long‐term venous access using Hickman catheters and implantable subcutaneous ports is a well established technique. These devices have customarily been inserted via the internal jugular, subclavian or cephalic veins. On occasions, these routes may be unavailable. This article reviews the outcome of 53 prolonged venous access catheters (39 Hickmans and 14 catheters attached to implantable ports) inserted percutaneously via the external iliac vein into 37 patients over a period of 5.7 years. The indications for insertion were chemotherapy (40%), total parenteral nutrition (36%), intravenous antibiotics (13%), poor venous access (7%) and bone marrow transplantation (4%). The main reasons for use of the external iliac vein were thrombosis of the subclavian veins or superior vena cava and subclavian central line sepsis. The only complication of insertion was one inadvertent puncture of the external iliac artery. Twenty‐seven catheters (51%) remained complication free and functioning for the time for which they were required. Four catheters (7%) are still functioning in situ having been present for 1–5 years. Sixteen catheters (30%) became infected, with a 17% incidence of septicaemia. Venous thrombosis was associated with three catheters (6%). Catheters remained in situ for a median period of 30 days (range 5–569 days). The authors conclude that long‐term venous access using percutaneous external iliac vein insertion is a useful technique when other routes are unavailable, but there is a relatively high incidence of catheter‐related sepsis.

    Original languageEnglish
    Pages (from-to)858-863
    Number of pages6
    JournalAustralian and New Zealand Journal of Surgery
    Volume63
    Issue number11
    DOIs
    Publication statusPublished - 1993

    Keywords

    • catheter
    • implantable
    • infection
    • percutaneous
    • thrombosis
    • vascular access.

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