What is placement of a subclavian venous infusion catheter with an external lumen?

Placement of a subclavian venous infusion catheter with an external lumen is a procedure in which the doctor places a catheter, or tube, into a large vein in the upper part of the chest under the collar bone with the other end located outside the skin.

When is it used?

This procedure allows you to take drugs without having a needle repeatedly inserted into your vein.

Examples of alternatives are:

• to have the drugs injected into one of the smaller veins lying close to the surface of your skin

• to have an implantable catheter with an implantable target

• to choose not to have this procedure.

You should ask your doctor about these choices.

How do I prepare for the procedure?

No special preparation is needed for local anesthesia.

What happens during the procedure?

You will receive a local anesthetic. This drug should keep you from feeling pain.

The doctor will make a small cut in your upper chest. He or she will place one end of the catheter into a large vein in your chest and lead the other end under the skin away from the puncture site. The doctor will bring this end of the catheter out to the surface of the skin and fit it with a cap that needles can go through. This is called an external lumen. The doctor will sew the cut closed.

What happens after the procedure?

You will be under observation for a few hours. You may then go home but should avoid strenuous activity for the rest of the day.

You will need to have the catheter for as long as you need injections of medication.

Ask what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

You may take medicine by injection through the external lumen, avoiding the pain and discomfort of injections into your veins and the damage to your veins from the needles and the strong medications.

What are the risks associated with this procedure?

• A local anesthesia may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia.

• By inserting the catheter into a vein in your chest, the doctor may tear the lung cavity or the lung. This could cause the lung to collapse, which would require another procedure under local anesthetic to reexpand the lung.

• The longer you have the catheter, the greater the risk of infection. If you get an infection, the catheter will probably have to be removed.

• A clot may form around the tip of the catheter in the vein and block the catheter or block the vein and make your arm swell.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.

• You become short of breath.

• You develop swelling in your arm on the side of the catheter.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.