Article OriginalRepérage électromagnétique des cathéters veineux centrauxAn electromagnetic locating system for central venous catheters
1992
A new technique, the Cath Finder ® (Pharmacia Deltec) system, for locating central venous catheters is described. It was initially designed to facilitate the insertion of the PAS Port ® (Pharmacia Deltec), a long central venous catheter with an implantable chamber. It is based on a low intensity high frequency electromagnetic field generated by a locator wand. A preconnected sensor guide wire is introduced into the catheter so as to make the catheter tip detectable by the electromagnetic field. The wand is placed over an appropriate landmark on the anterior chest wall (third right rib, parasternally). When the centre of the field has been passed over by the sensor tip in the catheter-sensor assembly, a light signal is set off. This technique is simple and easily mastered. It is far less cumbersome than the usual techniques, like fluoroscopy and chest X-rays. The Cath Finder ® provides reliable continuous information on the position of the catheter tip during its insertion. It seems to provide an acceptable alternative to peroperative fluoroscopy. The accuracy of this system was assessed in ten patients. All had malignancies and required long term central venous access. In 6 cases, catheterisation and locating of the catheter were uneventful. In 2 cases, the catheter entered a wrong vein. The diagnosis having been made with the Cath Finder ® system, the false route was amended and the catheter placed accurately. In one case, the sensor in the catheter broke. In an obese patient, there was a difference in catheter tip location given by fluoroscopy and the Cath Finder ®, because of the wrong incline given to the locator wand by the patient's chest wall. Although this non invasive technique requires a confirmatory chest X-ray for medico-legal reasons, its use in every central venous catheterization is recommended, especially in children.
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