Palermo S, Campolucci A, Capozza F, Cammardella M P, Balestrero A, Ferrando F, Basta P, Launo C
Istituto di Anestesiologia a Rianimazione Università degli Studi, Genova.
Minerva Anestesiol. 1995 Nov;61(11):451-6.
The authors describe their experience about long-term VAD (Venous Access Devices) placement and in particular of placement techniques types of catheters, complications, and risk and benefit. 243 placements of VAD in 112 males and 131 females mainly affected by leukemia or breast cancer have been analyzed. 145 Leonard, 54 Groshong and 44 Hickman type silicon catheters have been implanted. The preferred access vein was the right internal jugular vein in 75% of patients and the right subclavian vein in the remained. The results show implant success in 98.7% of the patients. Complications have been rare and not serious and they have been divided into: 1) complications due to venipuncture, 2) complications during implant, 3) complications during the staying of catheter, 4) complications during the removal. The authors underline the advantages of puncture access through the right internal jugular vein in comparison with access through the right subclavian vein. Groshong type catheter is better than Leonard and Hickman. Very few infections have been noticed and patients seem to accept more willingly percutaneous placement than surgical one.
作者描述了他们在长期置入静脉通路装置（VAD）方面的经验，特别是关于置管技术、导管类型、并发症以及风险和益处。分析了主要受白血病或乳腺癌影响的112名男性和131名女性患者的243次VAD置入情况。已植入145根伦纳德型、54根格罗雄型和44根希克曼型硅胶导管。75%的患者首选的穿刺静脉是右颈内静脉，其余患者首选右锁骨下静脉。结果显示98.7%的患者植入成功。并发症很少且不严重，可分为：1）静脉穿刺引起的并发症，2）植入过程中的并发症，3）导管留置期间的并发症，4）拔除过程中的并发症。作者强调了与通过右锁骨下静脉穿刺相比，通过右颈内静脉穿刺的优势。格罗雄型导管优于伦纳德型和希克曼型。感染情况极少，而且患者似乎更愿意接受经皮置管而非手术置管。
