• G K Nazarian, H Bjarnason, C A Dietz, C A Bernadas, and D W Hunter.
• Department of Radiology, University of Minnesota School of Medicine, Minneapolis 55455-0392, USA.
• J Vasc Interv Radiol. 1997 May 1;8(3):437-41.

PurposeTo determine the relative changes in position of tunneled catheters from supine to upright patient position and factors affecting catheter tip migration.Materials And MethodsOne hundred forty-six different tunneled catheters were placed through the subclavian or jugular veins radiologically, and catheter positions were documented with use of cine radiography at the time of placement. Follow-up chest radiographs were obtained with the patient in the upright position within 48 hours after placement. Catheter tip positions were numbered from 1 to 8, with 1 representing the innominate/superior vena cava junction and 8, the lower right atrium. Patient sex and weight, the site of catheter entry, and the size and type of catheter were correlated with the relative change in position on the follow-up chest radiogrpahs.ResultsThere was a statistically significant (P < .0001) change in catheter position on the follow-up chest radiographs, with a mean difference of 1.5 catheter positions (usually mid-right atrium initially to low superior vena cava on follow-up). Catheter tip migration was greater for catheters in the subclavian veins, in females, and in obese patients.ConclusionsThe catheter tip migrates significantly from the initial position at the time of placement as compared to when the patient assumes the upright position. This knowledge is important in achieving the desired final catheter position.

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