Accesso Venoso centrale. Confronto tra diverse metodiche.

A series of 168 consecutive patients that underwent percutaneous superior vena cava catheterization from 1987 to 1991 were retrospectively studied (mean age of 52 years, 42.3% women). 70.2% of the attempts were performed in emergency. Attending physicians of our surgery center attempted 75% of the catheterizations (mean operating time for the insertion 23 minutes). Cannulation of the vein was successful 156 times (92.8%). 73.7% of these catheters functioned without complications (mean duration of catheter function was 47 days). No early or late complications during unsuccessful attempts of cannulations were observed (12 cases). A total of 13 (8.2%) early complications were observed. There were 26.3% complications leading to removal of the catheter (infections 24.8%). Catheters related infections were no proven in 20% of removed catheter. Evaluation of our experience with this method lead us to conclude that the percutaneous method of superior vena cava catheterization is safest, fastest, efficient and cost effective method of obtaining central venous access, without requiring the sacrifice of vessels. Therefore we think that the useful of this methods is indispensable for a general surgeon.