Complications of radiologically placed central venous ports and Hickman catheters in patients with AIDS.

ABSTRACT

OBJECTIVE: To determine any differences in the complications following radiologic placement of 2 devices--Hickman catheters and central venous ports--to permit long-term central venous access in patients with AIDS. PATIENTS AND METHODS: Thirty-eight patients with AIDS received 52 long-term central venous access catheters. Seventeen received 23 Hickman catheters and 27 received 29 central venous ports (hence, 6 patients received both). Complications rates were determined retrospectively from clinical records and radiologic studies. RESULTS: The only acute complications were pneumothoraces--3 in the patients receiving Hickman catheters and 2 in the patients receiving central venous ports. Infections developed in 12 of the patients receiving Hickman catheters a median of 53 and a mean of 96 days after placement. Infection developed in 8 of the patients receiving central venous ports a median of 125 days and a mean of 184 days after placement. This difference was statistically significant (p < 0.001). The most common organism in these infections was Staphylococcus aureus. The only other nonacute complication was 1 nonocclusive thrombosis of the superior vena cava, which occurred in a patient with a Hickman catheter 240 days after placement and resolved once the catheter was removed. CONCLUSION: Central venous ports are preferred over Hickman catheters for long-term central venous access in patients with AIDS.