Percutaneous Insertion of Hickman Central Venous Catheter: Jugular Approach

Traditionally, tunnelled central venous catheter insertions have been performed by surgeons. However, there is an increasing trend towards central catheters being placed by interventional radiologists under image guidance. The many advantages of inserting central catheters via the jugular approach under image guidance include reusable venous access, generally less waiting time compared with surgical placement, short fluoroscopy and procedural time, high success rate, paucity of major complications, no need for general anaesthesia, and the procedure being well tolerated by most patients. The subclavian vein provides alternative venous access, although insertion of catheters via this approach may lead to intimal hyperplasia, venous stenosis, venous thrombosis, or subsequent fracture of the catheter. Percutaneous insertion of Hickman central catheters via the jugular approach is therefore the preferred method. It offers a safe and effective alternative to surgical placement and the subclavian approach.