Takasugi JK, O’Connell TX. Prevention of complications in permanent central venous catheters. Surg Gynecol Obstet 1988;167(July):6-11.

As more patients are requiring permanent central venous catheters (PCC) for long term venous access, several associated complications have become evident, including: 1, sepsis; 2, thrombophlebitis; 3, insertion complications, such as unsuccessful placement, bleeding and pneumothorax; and 4, PCC transection with tip embolization. At our institution, 162 PCC were placed by way of cutdown or percutaneously. Sepsis occurred in 20 percent (0.13 septic episodes per 100 catheter days), nearly always involved immunoccompromised patients. Twenty-five percent resolved with use of antibiotics and without removal of PCC. Two patients presented with clinical thrombophlebitis; both were treated with removal of PCC and anticoagulant medication. Failure of insertion was highest with the cephalic cutdown approach,, and pneuothorax was highest with the subclavian approach. Transection of PCC is associated with the percutaneous subclavian approach and is heralded by intermittent catheter function and a "pinch-off" sign on roentrgenogram. Methods of preventing these complications are emphasized.
Abstracted by permission from Surgery, Gynecology and Obstetrics.