Tunneled central venous access catheter placement in the pediatric population: comparison of radiologic and surgical results.
OBJECTIVE
To compare the success and infection rates of radiologic placement with those of surgical placement of tunneled central venous access catheters (TCVACs) in infants and small children.


METHODS
In 17 pediatric patients, TCVACs were placed with vascular access under ultrasound or fluoroscopic guidance in the radiology department. In 29 other patients, TCVACs were placed with percutaneous puncture or surgical cutdown in the surgery department.


RESULTS
Two (11%) of 18 attempts at radiologic placement were unsuccessful; six (38%) of the 16 radiologically placed catheters necessitated removal because of dislodgment, malfunction, or infection; six (38%) were electively removed; and four (25%) still function. Eight (23%) of 35 attempts at surgical placement were unsuccessful; 17 (63%) of the 27 surgically placed catheters required removal because of dislodgment, malfunction, or infection; nine (33%) were electively removed; and one (4%) still functions.


CONCLUSIONS
The success and infection rates of radiologic placement of TCVACs were similar to those of surgical placement. Radiologic placement required fewer attempts and was slightly less expensive.
Nosher
J L
JL
Department of Radiology, Robert Wood Johnson University Hospital, New Brunswick, NJ 08903-0019.
Shami
M M
MM
Siegel
R L
RL
DeCandia
M
M
Bodner
L J
LJ
D000293:Adolescent; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D011677:Punctures; D015641:Radiography, Interventional; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional