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A Journal on Surgery

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Chirurgia 1999 June;12(3):209-14


language: Italian

Inferior Vena Cava implant of permanent central venous access devices

D’Angelo F., Ramacciato G., Aurello P., Caramitti A., Lauro S., Lanzetta G.


Background. The implants of permanent central venous access devices (PCVAD) are considerably increasing in the last years. Standard technique suggests the Superior Vena Cava (SVC) positioning of the catheter, while impossibility to use this vessel requires, in a limited number of cases, the implant in an alternative vessel.
Methods. In a personal experience of 158 PCVAD implanted from January 1992 to April 1997, a total of 6 catheters have been positioned in the Inferior Vena Cava (IVC) through great saphenous vein cut-down (3.79%). In all cases alternative implant technique has been used when standard SVC positioning has been contraindicated.
Results. There were no morbidity cases in IVC implant in our limited experience, with an average implant lenght of 311 day (ranging 12-820 day). In the same period, in a total of 152 PCVAD positioned in SVC, complications occurred in 14 cases (8.6%), 5 sepsis, 3 mechanical, 4 flebothrombosis, 2 catheter obstruction respectivelly; 10 PCVAD have been removed for complications. The average implant lenght has been 366.8 day (range 5-1485 day).
Conclusions. From the analysis of our cases the conclusions is drawn that IVC implant should be reserved to selected cases, when the standard SVC access is contraindicated. Moreover IVC implant is of easy technical execution and, in our limited experience, free of morbidity, suggesting a more liberal use of this alternative technique.

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