RESUMEN
In the past 20 years Hickman catheters have gained increasing acceptance for many uses, including bone marrow transplantation, long-term chemotherapy, total parenteral nutrition, dialysis, and administration of antibiotics and fluids. Until the past decade these catheters were inserted in the operating room. We present our experience in the percutaneous placement of 203 Hickman catheters in an interventional radiology suite in 190 consecutive patients within a period of 30 months. Catheter placement was successful in 202 (99.5%). The main complications were infections, necessitating removal of the catheter in 11 cases (5.4%) and unintentional dislodgement of the catheter in 8 (3.9%)-all in women and most on the right side. Pneumothorax and thrombosis in the catheter each occurred once. In another patient the guide wire broke during insertion and had to be percutaneously removed from the pulmonary artery. Late fracture of the catheter occurred in 2 others in whom the intravascular fragment was removed percutaneously. We believe that percutaneous Hickman catheter placement in the radiology suite offers advantages over traditional surgical placement.
Asunto(s)
Cateterismo Venoso Central , Radiología Intervencionista , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/instrumentación , Falla de Equipo , Femenino , HumanosRESUMEN
One thousand consecutive skull x-rays in patients with head trauma were reviewed. Only eighteen (1.8%) showed a fracture. Four of these were depressed. Thirteen of the 18 patients were below 15 years of age and 15 were males. Two patients had evidence of intracranial trauma on computed tomography (CT). The outcome was favorable in all patients. In view of the extremely low yield of skull x-rays for trauma, we believe that this examination is no longer indicated as a routine procedure. Patients with a suspected intracranial injury should be evaluated by CT study.