title: Percutaneous insertion of subclavian Hickman catheters.
abstract: We have assessed the percutaneous insertion of Hickman catheters implanted directly into the subclavian vein; 116 catheters were inserted in 86 patients. The catheters were all inserted by members of the haematology staff. The majority of the catheters were inserted under local anaesthetic in a haematology ward with filtered positive pressure ventilation. X-ray screening was not routinely used. The average patient age was 45 years and the average platelet count was 155 x 10(9)/l. Sixty-seven per cent of the catheters either remain in situ or have been removed electively or at death. The remainder have been removed for a variety of reasons (infection 10%, suspected infection 8%, accidental dislodgement 7%, thrombosis 4%, catheter blockage 3%, catheter fracture 0.9%). The only complication specific to direct subclavian puncture was pneumothorax (4%). This disadvantage may be offset by rapid insertion, a cosmetically superior result and the avoidance of surgical and operating theatre time.
authors.affiliation: Department of Haematology, East Birmingham Hospital, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Morton
authors.forename: R M
authors.initials: RM
authors.lastname: Jan-Mohamed
authors.forename: H F
authors.initials: HF
authors.lastname: Barker
authors.forename: D W
authors.initials: DW
authors.lastname: Milligan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods; D002408:Catheters, Indwelling; D006801:Humans; D008875:Middle Aged; D013350:Subclavian Vein / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000379:methods*