Experience of anesthesiologists with percutaneous nonangiographic venous access

Study ObjectiveTo compare percutaneous nonangiographic insertion of a venous access device with a standard surgical cutdown insertion technique.DesignProspective, controlled, randomized study.SettingOperating room and anesthesia induction room of a university hospital.Patients100 consecutive oncology patients scheduled for intravenous chemotherapy.InterventionsPatients were randomized to two groups: (1) The percutaneous group received implantation through the internal jugular vein by experienced anesthesiologists, whereas (2) the surgical group received venous cutdown insertion through the cephalic or subclavian vein by surgeons (n = 50 for each group).MeasurementsDuration of procedure, long-term device function, complications such as hematoma formation, infection, hemothorax, pneumothorax, and patients' satisfaction with the placement procedure at two months of follow-up were all measured and recorded.Main ResultsThe percutaneous technique was found to have several advantages, including reduced time for insertion and greater patient satisfaction with procedure. The percutaneously implanted devices also had fewer insertion-associated complications.ConclusionThe simplified, percutaneous, nonangiographic technique is as effective as the traditional venous cutdown technique and can be safely done by surgeons as well as by experienced physicians who are not surgeons.