Editorials

Insertion of long term central venous catheters: time for a new look

Central venous catheters and ports are used to administer chemotherapy, antibiotics, parenteral nutrition, blood products, and cardiovascular pressor agents. Catheters are being used more commonly as more patients are being treated for leukaemia, solid tumours, infection, and AIDS.¹ The prototype central venous catheter inserted via a subcutaneous tunnel for long term use is the Hickman catheter.² At present such catheters may be inserted in three ways: by a surgical venous cutdown or by percutaneous puncture with or without imaging guidance.

Traditionally central venous catheters for long term use have been inserted by surgeons using a cutdown technique in the operating theatre under general anaesthesia. The catheter was inserted into the subclavian vein and advanced along the superior vena cava to the right atrium. The drawbacks of this method include a relatively low success rate (75%), . . . [Full text of this article]

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