Experience of anesthesiologists with percutaneous nonangiographic venous access

Abstract

Study Objective To compare percutaneous nonangiographic insertion of a venous access device with a standard surgical cutdown insertion technique. Design Prospective, controlled, randomized study. Setting Operating room and anesthesia induction room of a university hospital. Patients 100 consecutive oncology patients scheduled for intravenous chemotherapy. Interventions Patients were randomized to two groups: (1) The percutaneous group received implantation through the internal jugular vein by experienced anesthesiologists, whereas (2) the surgical group received venous cutdown insertion through the cephalic or subclavian vein by surgeons (n = 50 for each group). Measurements Duration of procedure, long-term device function, complications such as hematoma formation, infection, hemothorax, pneumothorax, and patients' satisfaction with the placement procedure at two months of follow-up were all measured and recorded. Main Results The percutaneous technique was found to have several advantages, including reduced time for insertion and greater patient satisfaction with procedure. The percutaneously implanted devices also had fewer insertion-associated complications. Conclusion The simplified, percutaneous, nonangiographic technique is as effective as the traditional venous cutdown technique and can be safely done by surgeons as well as by experienced physicians who are not surgeons.