Tunneled catheters placed in bone marrow transplant patients: radiological and clinical follow-up results.

PURPOSE To present the radiological and clinical follow-up results of 75 bone marrow transplant patients who underwent fluoroscopy-guided tunneled catheter placement between June 2001 and June 2004. MATERIALS AND METHODS Tunneled catheters were placed in 75 bone marrow transplant patients with fluoroscopic guidance. The left subclavian vein was used in 67 patients, whereas the right side was used in 9. RESULTS The first attempt of catheter insertion was failed in 3 patients who then underwent contralateral catheter placement. No complications were noted during or immediately after the procedures. Late complications included 8 cases of infection, 2 cases of fibrin sheath formation, and 1 case of persistent hiccups, which began at the time of catheter insertion. Inadvertent catheter removal was noted in 4 cases. CONCLUSION Fluoroscopy-guided central venous catheterization should be preferred over the anatomical landmark technique due to its higher technical success rate, shorter procedure time, and lower complication rate. When placing a central venous catheter, multiple factors should be considered, such as catheter type, number of lumens, duration and frequency of pertinent treatments, and patient needs. The procedural and early post-procedural complications were mostly related to the placement technique; however, the late complications could have been prevented by nurse care and patient education.