We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence and Brief Communications |

Cephalic Vein Cutdown Approach for Long-term Indwelling Central Venous Access

Stephen P. Povoski, MD
Arch Surg. 2002;137(6):746. doi:.
Text Size: A A A
Published online


I would like to acknowledge and commend the timely and informative article written by Di Carlo et al1 in the September 2001 issue of the ARCHIVES that described the placement of totally implantable venous access devices using the cephalic vein cutdown approach as the preferred insertion technique. However, I believe that several aspects of their article warrant reflection and discussion.

The first detailed description of the cephalic vein cutdown approach for long-term indwelling central venous access was published in 1976 by Heimbach and Ivy.2 Since that time, numerous articles have been published describing this technique, with some series specifically reporting the frequency of successful catheter placement with the cephalic vein cutdown approach (cumulative results from 9 such series: 80.8%, or 1785 of 2210 patients). In the article by Di Carlo et al,1 the authors fail to give well-deserved recognition to Heimbach and Ivy for their detailed initial description of the cephalic vein cutdown approach or to acknowledge or use many of the previously reported series on this approach to critically compare and contrast their own impressive results.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections