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Percutaneous insertion of tunnelled central venous catheters is a safe out-patient procedure

The study was performed to evaluate prospectively the efficacy and safety of insertion of tunnelled central venous catheters as an out-patient procedure in the radiology department. Tunnelled central venous catheters were inserted via the jugular or subclavian veins in 94 patients. The insertion was guided by ultrasound or venography. A post-procedure chest radiograph was obtained and, if the patients were well, they were discharged from hospital after 2h. Insertion was successfully achieved in all patients. Early complications occurred in 19 patients (20.2%) but these were generally minor. A chest drain was inserted into one patient who had a pneumothorax on the post-procedure chest radiograph. All other patients were fit to go home. Late complications occurred in 32 patients (34%), resulting in death in one patient. This study suggests that, with appropriate precautions, out-patient percutaneous image-guided insertion of tunnelled central venous catheters is a safe procedure.