Cephalic vein cut-down verses percutaneous access: a retrospective study of complications of implantable venous access devices

Am J Surg. 2006 Jul;192(1):63-7. doi: 10.1016/j.amjsurg.2005.11.012.


Background: Central venous access devices play an integral role in providing long-term venous access. Percutaneous and cut-down techniques have been used with varying complications.

Methods: Between January 1998 and July of 2001, 358 venous access devices were placed at Albert Einstein Medical Center in Philadelphia, Pennsylvania. A retrospective study was performed to compare complications and operative times for 2 methods of catheter insertion.

Results: Overall complication rate was 14%. In lines successfully placed percutaneously, the complication rate was 15% (25 of 163) compared with 11% (16 of 148) in the successful cephalic cut-down group, P = .11. Complications including -- pneumothorax, late catheter transection, and bradycardia -- only occurred in percutaneously placed lines. Mean operative times were similar for both groups.

Comments: Use of the cut-down approach for long-term venous access may result in improved patient safety. The cut-down technique should be considered a safe initial approach for placement of venous access devices.

Publication types

  • Comparative Study

MeSH terms

  • Brachiocephalic Veins / surgery*
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation
  • Catheters, Indwelling
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Venous Cutdown / adverse effects*
  • Venous Cutdown / methods