Openshaw K L, Picus D, Hicks M E, Darcy M D, Vesely T M, Picus J
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
J Vasc Interv Radiol. 1994 Jan-Feb;5(1):111-5. doi: 10.1016/s1051-0443(94)71464-0.
Hohn catheters are single- or double-lumen catheters used for intermediate-length central venous access. The authors report their technique, results, and long-term follow-up in a prospective study of their first 100 consecutive patients.
Indications for Hohn subclavian catheter placement included chemotherapy in 53%, antibiotic therapy in 30%, and total parenteral nutrition in 8%. Patients' ages ranged from 21 to 82 years, and 80% of catheters were placed in inpatients. Hohn catheters were placed with fluoroscopic and/or ultrasound guidance. Patients were followed up for the duration of the study or until their catheters were removed.
The technical success rate for catheter placement was 100%. No major procedural complications occurred. Duration of catheter placement varied between 5 and 276 days (mean, 70 days). The catheter infection rate was 8%, which corresponds to 1.1 infections per 1,000 catheter days. Catheter thrombosis occurred in nine cases (9%) and was successfully treated with urokinase in six of these nine. Subclavian vein thrombosis occurred in 3% of patients.
Technical success, complication, and long-term patency rates for the Hohn catheter are comparable to or better than those in most surgical series involving tunneled external catheters. The Hohn catheter is an excellent alternative for intermediate-length central venous access. Hohn subclavian catheter placement has become a standard part of the authors' interventional radiology service and is easily adaptable to all interventional practices.
霍恩导管是用于中等长度中心静脉通路的单腔或双腔导管。作者在对连续100例患者的前瞻性研究中报告了他们的技术、结果和长期随访情况。
放置霍恩锁骨下导管的适应证包括化疗(53%)、抗生素治疗(30%)和全胃肠外营养(8%)。患者年龄范围为21至82岁,80%的导管放置于住院患者。霍恩导管在透视和/或超声引导下放置。对患者进行了整个研究期间的随访或直至其导管被拔除。
导管放置的技术成功率为100%。未发生重大操作并发症。导管放置时间为5至276天(平均70天)。导管感染率为8%,相当于每1000导管日发生1.1次感染。9例(9%)发生导管血栓形成,其中6例用尿激酶成功治疗。3%的患者发生锁骨下静脉血栓形成。
霍恩导管的技术成功率、并发症发生率和长期通畅率与大多数涉及隧道式外置导管的外科系列相当或更好。霍恩导管是中等长度中心静脉通路的极佳替代选择。霍恩锁骨下导管放置已成为作者介入放射科服务的标准组成部分,并且很容易适用于所有介入操作。