{
    "abstract": "A chest radiograph has traditionally been performed following the insertion of a tunnelled Hickman catheter to immediately exclude rare but potentially serious complications such as pneumothorax and haemothorax and confirm appropriate positioning of the catheter tip. The value of completing the routine chest radiograph has been questioned when fluoroscopic image may be easily obtained in the angiography suite for the same purpose, and the rate of iatrogenic pneumothorax remains extremely low in the Medical literature. We describe our experience of performing Hickman catheter insertion under ultrasound and fluoroscopic guidance and whether routinely performing the chest radiograph is justifiable.\nA single centre retrospective review was performed of patients who received a tunnelled Hickman catheter and underwent postprocedural chest radiograph in the Interventional Radiology Department during a fifteen-year period from August 2007 to April 2021. Patient demographics and complications were documented.\nDelayed iatrogenic pneumothorax was diagnosed in one asymptomatic patient (0.06%) on a chest radiograph out of 1735 patients, and they required chest tube insertion. Other complications included two cases of right common carotid artery puncture, one case of right internal jugular vein dissection and one case of left internal jugular perforation. Two patients required a repeat procedure within 24\u2009h due to superior migration of the Hickman catheter on chest radiograph.\nGiven the extremely low rate of iatrogenic pneumothorax, chest radiograph following the insertion of a tunnelled Hickman catheter under ultrasound and fluoroscopic guidance may be an unnecessary investigation unless the patient is symptomatic, or there is sufficient clinical concern.",
    "authors": [
        {
            "affiliation": null,
            "firstname": "Kosuke",
            "initials": "K",
            "lastname": "Kato"
        },
        {
            "affiliation": "Department of Radiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.",
            "firstname": "Calvin",
            "initials": "C",
            "lastname": "Gan"
        },
        {
            "affiliation": "Department of Radiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.\nDepartment of Radiology, The University of Melbourne, Melbourne, Victoria, Australia.",
            "firstname": "Alexander",
            "initials": "A",
            "lastname": "Rhodes"
        }
    ],
    "conclusions": "Given the extremely low rate of iatrogenic pneumothorax, chest radiograph following the insertion of a tunnelled Hickman catheter under ultrasound and fluoroscopic guidance may be an unnecessary investigation unless the patient is symptomatic, or there is sufficient clinical concern.",
    "copyrights": "\u00a9 2022 Royal Australian and New Zealand College of Radiologists.",
    "doi": "10.1111/1754-9485.13479",
    "journal": "Journal of medical imaging and radiation oncology",
    "keywords": [
        "Hickman",
        "catheters",
        "fluoroscopy",
        "iatrogenic disease",
        "pneumothorax"
    ],
    "methods": null,
    "publication_date": "2022-09-27",
    "pubmed_id": "36161771",
    "results": "Delayed iatrogenic pneumothorax was diagnosed in one asymptomatic patient (0.06%) on a chest radiograph out of 1735 patients, and they required chest tube insertion. Other complications included two cases of right common carotid artery puncture, one case of right internal jugular vein dissection and one case of left internal jugular perforation. Two patients required a repeat procedure within 24\u2009h due to superior migration of the Hickman catheter on chest radiograph.",
    "title": "Necessity of performing a routine chest radiograph following the insertion of tunnelled Hickman catheter under imaging guidance: A single centre experience.",
    "xml": "<Element 'PubmedArticle' at 0x78850342f100>"
}