title: Placement of long-term central venous catheters in outpatients: study of 134 patients over 24,596 catheter days.
abstract: OBJECTIVE
  Our goal was to investigate the feasibility of inserting long-term central venous access devices in outpatients using a simple technique that minimizes the risks of complications linked to venipuncture and errors in management.
  
  
  METHODS
  We placed 147 central venous catheters (CVCs) in 134 patients under local anesthesia. No sedation was used, and all procedures were done in our radiology department. Of the 134 patients, 101 patients were included in the follow-up. Overall follow-up of patients was 24,596 catheter days (mean, 243.52 days). Percutaneous access, mostly by the subclavian vein, was done by micropuncture technique under fluoroscopic guidance. Six CVCs were untunneled, 36 were connected to totally subcutaneous ports, and 105 were tunneled.
  
  
  RESULTS
  The only immediate complication was pneumothorax (3%). Late complications, expressed per 1000 catheter days, included CVC breakage (0.12), vascular thrombosis (0.08), catheter occlusion (0.04), dislodgment (0.24), and local or systemic infections (0.40).
  
  
  CONCLUSIONS
  Outpatient CVC placement is feasible because the procedure is not adversely affected when the patient is not hospitalized. The drawbacks are identical to those faced by inpatients. Improved materials and more extensive information on the management of patients with long-term CVCs would help reduce complications further.
authors.affiliation: Department of Interventional Radiology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Damascelli
authors.forename: G
authors.initials: G
authors.lastname: Patelli
authors.forename: L F
authors.initials: LF
authors.lastname: Frigerio
authors.forename: R
authors.initials: R
authors.lastname: Lanocita
authors.forename: F
authors.initials: F
authors.lastname: Garbagnati
authors.forename: A
authors.initials: A
authors.lastname: Marchianò
authors.forename: C
authors.initials: C
authors.lastname: Spreafico
authors.forename: G
authors.initials: G
authors.lastname: Di Tolla
authors.forename: L
authors.initials: L
authors.lastname: Monfardini
authors.forename: G
authors.initials: G
authors.lastname: Porcelli
mesh_terms: D000553:Ambulatory Care / Q000379:methods; D000772:Anesthesia, Local; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D004868:Equipment Failure; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology; D013350:Subclavian Vein; D013927:Thrombosis / Q000453:epidemiology; D013997:Time Factors