Image-guided placement of long-term central venous catheters reduces complications and cost

Am J Surg. 2014 Dec;208(6):937-41; discussion 941. doi: 10.1016/j.amjsurg.2014.08.005. Epub 2014 Sep 22.

Abstract

Background: The goals of this study were to evaluate the complication rate for intraoperative placement of a long-term central venous catheter (CVC) using intraoperative ultrasound (US) and fluoroscopy and to examine the feasibility for eliminating routine postprocedure chest X-ray.

Methods: Retrospective data pertaining to operative insertion of long-term CVC were collected and the rate of procedural complications was determined.

Results: From January 2008 to August 2013, 351 CVCs were placed via the internal jugular vein using US. Of these, 93% had a single, successful internal jugular vein insertion. The complications included 4 arterial sticks (1.14%). Starting in October 2012, postprocedure chest radiography (CXR) was eliminated in 170 cases, with no complications. A total of $29,750 in charges were deferred by CXR elimination.

Conclusions: This review supports the use of US for CVC placement with fluoroscopy in reducing the rate of procedural complications. Additionally, with fluoroscopic imaging, postprocedural CXR can be eliminated with associated healthcare savings.

Keywords: Central venous catheters; Fluoroscopy; Image guided; Long-term central venous catheter; Postprocedural chest X-ray; Ultrasound guided.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheterization, Central Venous / methods*
  • Female
  • Fluoroscopy
  • Humans
  • Jugular Veins
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / prevention & control
  • Radiography, Interventional*
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Interventional*