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Venous Access (Hickmann Lines)

A tunnelled Hickmann line is required when patients need long term venous access for drug treatments. Placing a silicone catheter into a large fast flowing vein allows drugs to be rapidly diluted. This reduces the risk of the vein blocking (thrombosing). Multiple injections can be made through the Hickmann line, thus avoiding the need for repeated needles. Since a Hickmann line is tunnelled under the skin, the risk of infection in the vein is also reduced.

Using new minimally-invasive techniques, it is possible to place these lines rapidly and safely, usually under local anaesthetic. The procedure usually takes 15-25 minutes. A Duplex (ultrasound) machine is used to identify the jugular vein, and a portable x-ray machine is used to check the position of the line after it has been inserted. Patients can usually return home and / or start their drug treatment the same day.

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Once the drug treatment has been completed, removal of the line is straightforward. Short-term risks of line insertion include collapsed lung or bleeding (both occur very rarely). Longer-term risks include infection of the line or blocking of the line / vein.

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