title: Image-guided placement of long-term central venous catheters reduces complications and cost.
abstract: BACKGROUND
  The goals of this study were to evaluate the complication rate for intraoperative placement of a long-term central venous catheter (CVC) using intraoperative ultrasound (US) and fluoroscopy and to examine the feasibility for eliminating routine postprocedure chest X-ray.
  
  
  METHODS
  Retrospective data pertaining to operative insertion of long-term CVC were collected and the rate of procedural complications was determined.
  
  
  RESULTS
  From January 2008 to August 2013, 351 CVCs were placed via the internal jugular vein using US. Of these, 93% had a single, successful internal jugular vein insertion. The complications included 4 arterial sticks (1.14%). Starting in October 2012, postprocedure chest radiography (CXR) was eliminated in 170 cases, with no complications. A total of $29,750 in charges were deferred by CXR elimination.
  
  
  CONCLUSIONS
  This review supports the use of US for CVC placement with fluoroscopy in reducing the rate of procedural complications. Additionally, with fluoroscopic imaging, postprocedural CXR can be eliminated with associated healthcare savings.
authors.affiliation: Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Bowen
authors.affiliation: Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Mone
authors.affiliation: Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Nelson
authors.affiliation: Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: courtney.scaife@hsc.utah.edu.
authors.forename: Courtney L
authors.initials: CL
authors.lastname: Scaife
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Central venous catheters; Fluoroscopy; Image guided; Long-term central venous catheter; Postprocedural chest X-ray; Ultrasound guided