The type of catheter that is best for you will depend on your underlying condition, the type of treatment that you are having, your lifestyle, and how long you are having your treatment for. The various options will be discussed with you to help you make a decision.
It usually takes about 30 - 60 minutes to put a central line in and this is normally done as a day case in hospital. The procedure is done in the operating theatre. Removal of portacaths and Hickman lines requires a short operation in the operating theatre that takes about 30 minutes. PICC lines and temporary central lines can be simply removed on the ward and do not require an operation.
I normally do the operations under local anaesthetic and sedation; you should not need a general anaesthetic. You will be able to have a light breakfast on the morning of your operation.
If you have had sedation then you will not be able to drive for 24 hours after the procedure.
You will need to look after your line; after all it is very precious! But do not worry, it is fairly simple. We will give you lots of support and help. You will find some more information under the specific procedures.
Having a central venous catheter is a fairly common procedure and is usually fairly straightforward. However, along with everything in medicine there are potential problems and complications.
Whenever we make a hole in the body there is the chance of discomfort, bleeding, bruising, infection, and damage to structures near the veins such as nerves, arteries, veins and lung. When we leave things in the body, then they can move out of position, get blocked, get infection or blood clot can form around them.
You may have some swelling and bruising after the procedure, and this may take a few weeks to completely settle down. If you are uncomfortable, then simple pain killers such as paracetamol should help. Occasionally you may have some pins and needles in your arm after the procedure, this should settle within 24 hours.
Avoid any vigorous exercise until the wounds have completely healed – this can take 2-3 weeks. Gentle exercise is fine.
It is possible for an infection to develop either inside the central line, around the exit site or port, or in the bloodstream. You should contact your doctor or nurse if:
You may be given antibiotics, and if the infection is serious, the line may have to be removed to help treat the infection. The risk of infection can be reduced by making sure that whenever anyone uses your line, they wash their hands and use a sterile technique.
It is possible for a blood clot (thrombosis) to form in your vein around the line. Often these are mild and cause no problems; however, if the clot is large it may cause symptoms such as swelling of the arms or face, or shortness of breath. If this does happen it is important that you contact your doctor or nurse. If a clot does form the line may have to be removed and you may also be given daily injections or tablets to help dissolve the clot.
Sometimes the vein around the line can narrow (stenose). This should not cause too many problems initially but it may make it difficult to insert lines in the future.
Very rarely the lung can collapse when the line is being inserted (a pneumothorax) - this is a very rare complication because of the way I insert the lines under ultrasound control. If it does happen then it normally settles on its own; occasionally a small drain has to be put into the chest cavity for a few days to help the lung re-expand.
I will leave the end of your line in a good position but occasionally the tip can move about. If this happens you may need another operation to reposition the line. Very rarely the tip of the catheter can work its way through the wall of the vein or the heart; this can be very serious but is fortunately extremely rare.
If you notice that the line is further out than normal, then contact your doctor or nurse immediately.
It is important that your line is flushed regularly to prevent a blockage of the line. Unfortunately, blockages can occur despite this. Sometimes these blockages can be treated using small doses of 'clot busting' drugs but occasionally the line has to be changed.
Rarely, the line can irritate the heart and cause abnormal heart rhythms or cause fluid to build up in the sac around the heart. If you feel any palpitations, light-headedness, dizziness or shortness of breath it is important to seek immediate medical advice.
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