The great saphenous vein for central venous access and haemodialysis.
BACKGROUND
Utilising an open surgical technique the Great Saphenous vein in the proximal thigh can be used for the insertion of central venous catheters for haemodialysis. This approach is safe and efficacious, and may be performed under local or general anaesthesia. This technique is of particular importance in patients requiring vascular access for haemodialysis in whom the upper central veins are stenosed and the femoral vessels are not amenable to percutaneous cannulation.


METHODS
The Great saphenous vein is exposed via a surgical incision in the thigh. The central venous catheter is then inserted and advanced until in the desired position, as confirmed on fluoroscopy.


RESULTS
Seven Great saphenous catheters were placed over a period of six months. All catheters insertions were technical successes with completion of at least one dialysis session. Primary patency rates were 57%, 49%, 23% at 30, 60 and 90 days respectively.


CONCLUSIONS
The great saphenous vein offers an additional site for the insertion of central venous catheters. These data demonstrate equivalence in patency between this novel technique and percutaneous femoral vein cannulation.
Yates
Phillip J
PJ
Department of Infection, University of Leicester, Leicester General Hospital, Leicester, UK. pjy4@le.ac.uk
Barlow
Adam D
AD
Johari
Yasha
Y
Doughman
Tahir
T
Nicholson
Michael L
ML
D002405:Catheterization, Central Venous / Q000379:methods* / Q000706:statistics & numerical data; D002408:Catheters, Indwelling; D005268:Femoral Vein / Q000601:surgery; D005471:Fluoroscopy; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000628:therapy; D006435:Renal Dialysis / Q000379:methods*; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*