Femorally inserted central venous catheter in patients with superior vena cava obstruction: choice of the optimal exit site.

PURPOSE: This study assessed patient comfort and catheter indwelling time and decreased incidence of complications in patients with femorally inserted venous catheters (FIVCs) via different exit sites.

METHODS: A group of 114 patients suffering from lung cancer complicated by superior vena cava obstruction (SVCO) underwent femoral insertion of venous catheters to facilitate chemotherapy infusion. Patients were divided into two groups: a novel (NOV) group (n = 59) with the FIVC exit site at the mid-thigh and a conventional (CON) group (n = 55) with the exit site at the groin. The clinical efficacy and safety were compared.

RESULTS: There were significant differences (p<0.001) between NOV and CON groups in bleeding scores (2.44 ± 0.62 vs. 1.36 ± 0.49), catheter indwelling time (195.08 ± 39.19 days vs. 91.53 ± 32.88 days), patient comfort scores (4.20 ± 0.87 vs. 1.35 ± 0.91), and pain scores (1.64 ± 0.91 vs. 2.42 ± 1.08). Significant differences (p<0.05) were also observed in catheter-associated thrombosis (1.69% vs. 14.55%), catheter exit site infection (1.69% vs. 21.82%), and the incidence of total complications (11.86% vs. 45.45%) between the NOV and CON groups. However, the differences in success rates between the NOV and CON groups during the first attempt (98.32% vs. 98.18%) and catheter obstruction (8.48% vs. 9.09%) were not significant (p>0.05).

CONCLUSIONS: Compared with the conventional exit site at the groin, the exit site at the mid-thigh for FIVCs increased patients' comfort and catheter indwelling time, and decreased the rate of complication and pain scores. However, it did not decrease the success rate in SVCO patients.