Peripheral Access for Implantable Venous Access Device

Abstract

ObjectiveTo assess the success of peripheral venous access for implantation of venous access device in large series of patients with the aim of avoiding central venous puncture with its potential complications and costs. DesignRetrospective cohort study. MethodsDuring a 4-year period (January 2001–December 2004), 302 consecutive patients underwent implantation of a venous access device. The first choice was peripheral venous access. If this failed the subclavian vein was punctured for access. ResultsAccess was gained via the cephalic vein in 246 patients (81%), in eight patients via other peripheral veins (3%) and the subclavian vein was punctured in 48 patients (16%). Pneumothorax occurred in two patients who underwent subclavian vein puncture (0.7% of all and 4% of patients with subclavian vein puncture) and was managed by insertion of a chest drain.There were no other perioperative complications. The average cost was 680 Euros for implantation via a peripheral vein and 993 Euros when the subclavian vein was used for access. Mean operating time for all 302 procedures was 36min. ConclusionsPeripheral venous access was possible in 84% of our patients and may be the access of first choice for implantation of venous access device to avoid central venous puncture with its potential morbidity, rare mortality and additional costs.