Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Factors Affecting Longevity of Tunneled Central Venous Catheters

터널형 중심정맥도관의 수명에 영향을 주는 인자들

  • Park, Ji-Won (Department of Radiology, Kyungpook National University Hospital) ;
  • Lee, Jong-Min (Department of Radiology, Kyungpook National University Hospital)
  • 박지원 (경북대학교병원 영상의학과) ;
  • 이종민 (경북대학교병원 영상의학과)
  • Published : 2011.12.01
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Abstract

Purpose: To evaluate factors which affect the longevity of tunneled central venous catheters (T-CVCs). Materials and Methods: A retrospective study was conducted on 363 T-CVCs. We evaluated the relevant factors affecting the longevity of the T-CVCs, such as age, gender, indication for catheterization, site of entry vessel, diameter and type of T-CVC, catheter tip position, and underlying diseases. Results: Of the 363 T-CVCs which had been inserted, 331 (91%) were placed through the right internal jugular vein (RIJV). The catheter tip position was the strongest predictor for the longevity of the T-CVC. The short limb of the catheter tip placed either at the cavoatrial junction (CA junction) or below the lower margin of the right main bronchus had a good prognosis. The vessel through which the T-CVC was placed significantly influenced the longevity of the T-CVC; the RIJV was associated with better results than the left internal jugular vein. Also, a split-type catheter was significantly associated with a better result. Conclusion: A two distinct and separate type T-CVC placed through the RIJV in which the short limb catheter tip position was at the level of the CA junction, significantly increased the longevity of T-CVCs.

목적: 터널형 중심정맥도관(이하 T-CVC)의 수명에 영향을 미치는 인자들을 분석해 보았다. 대상과 방법: T-CVC를 설치한 총 363예를 후향적으로 연구하였다. 나이, 성별, 시술 적응증, 삽입정맥, 도관의 직경 및 형태, 도관말단부 위치, 기저질환 등을 T-CVC의 수명에 영향을 미치는 인자로 설정하였고, 그 영향력을 분석하였다. 결과: 총 363예 중 331예(91%)는 우내경정맥을 통하여 설치되었으며 삽입정맥은 T-CVC의 수명에 영향력이 큰 인자였다(p < 0.001). 도관말단 위치는 가장 큰 영향력을 보였다. T-CVC의 짧은 가지 말단이 상대정맥-우심방 경계 수준에 위치하거나 우기관지 하연보다 하방에 위치한 경우 더 좋은 예후를 보였다. 또한 분리형 도관의 경우 더 좋은 결과를 보였다. 결론: 분리형 T-CVC가 우경정맥을 통해 설치되고 짧은 가지 말단이 상대정맥-우심방 경계 수준에 위치하는 경우 T-CVC의 수명은 유의하게 연장되었다.

Keywords

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