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  • Title: Cephalic vein cut-down verses percutaneous access: a retrospective study of complications of implantable venous access devices.
    Author: Jablon LK, Ugolini KR, Nahmias NC.
    Journal: Am J Surg; 2006 Jul; 192(1):63-7. PubMed ID: 16769277.
    Abstract:
    BACKGROUND: Central venous access devices play an integral role in providing long-term venous access. Percutaneous and cut-down techniques have been used with varying complications. METHODS: Between January 1998 and July of 2001, 358 venous access devices were placed at Albert Einstein Medical Center in Philadelphia, Pennsylvania. A retrospective study was performed to compare complications and operative times for 2 methods of catheter insertion. RESULTS: Overall complication rate was 14%. In lines successfully placed percutaneously, the complication rate was 15% (25 of 163) compared with 11% (16 of 148) in the successful cephalic cut-down group, P = .11. Complications including -- pneumothorax, late catheter transection, and bradycardia -- only occurred in percutaneously placed lines. Mean operative times were similar for both groups. COMMENTS: Use of the cut-down approach for long-term venous access may result in improved patient safety. The cut-down technique should be considered a safe initial approach for placement of venous access devices.
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