Discussion
thrombosis, infectious, thrombotic, silicone tCDC, tCDC
THROMBOSIS, COMPLICATIONS
The CITES trial is designed to provide robust data on whether the incidence of CVS after insertion of a silicone tCDC in the right subclavian vein is non-inferior compared to when using the internal jugular vein. This is clinically important as the subclavian route offers several advantages for the patient (e.g. less infectious and thrombotic complications) and because other routes are sometimes unavailable for catheterisation.The current study is not an evaluation of a clinical routine but rather aims to explore the proof of concept that the subclavian route is non-inferior to the internal jugular route with regard to the incidence of post-catheterisation CVS. This design is based on the knowledge that older studies [To allow for thrombosis and any temporary narrowing of central veins to resolve, a time interval for the CT venography of 1.5–3 months after removal of the tCDC was chosen.Data from the era of landmark-based catheterisations have indicated less misplacements when using the left-sided subclavian vein [The administration of intravenous contrast within the study is done in accordance with the European Society of Urogenital Radiology (ESUR) guidelines [Real-time ultrasound guidance is used in > 93% of central venous catheterisations at the hospitals within Region Skåne (unpublished data). Thus, it would seem prudent to also make use of the ultrasound equipment to verify that the central veins are patent prior to the procedure to save time and avoid added patient discomfort. In order to gain acceptance and allow for easy implementation, the protocol is kept simple (Additional file 