Insertion of an implantable venous access device in the groin using inferior epigastric vein.
BACKGROUND
Patients with cystic fibrosis (CF) need reliable venous access that can be provided by implantable venous access devices (IVAD). Such IVADs usually are placed in the upper part of the body, but placing them in this area has 3 disadvantages: a suitable vein may not be available, the portal may be conspicuous, and there may be interference with chest physiotherapy. Positioning the IVAD in the groin by using the inferior epigastric vein (IEV) is an answer to these problems.


METHODS
This is a review of 29 patients from a single surgeon's practice from 1984 to 1999. A groin incision was used to implant the IVAD and to introduce the catheter via the IEV to the inferior vena cava.


RESULTS
A total of 33 IVAD were inserted in 29 patients (27 with CF). The average age at first operation was 12.4 years. Infection was seen in 5. Venous thrombosis was not seen in any patient. The average longevity of IVAD is 18.5 months. Total experience is 87 IVAD years.


CONCLUSIONS
This is a useful route of first choice for CF patients, with an overall complication rate comparable with techniques in which IVADs are placed in the upper half of body. J Pediatr Surg 36:579-581.
Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, NSW, 2145, Australia.
S J
SJ
Singh
H C
HC
Martin
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000188:drug therapy*; D004869:Equipment Safety; D005260:Female; D006119:Groin / Q000098:blood supply*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014680:Veins