Hickman catheter

Hickman catheters (or Hickman lines) are a type of tunneled central venous access line.

Radiographic features

Hickman catheters are typically inserted into either jugular vein, and the proximal tubing is tunneled through the subcutaneous tissues to a skin incision on the chest. The distal part of the catheter therefore follows the normal course of a jugular venous catheter, with its tip in the region of the superior cavoatrial junction. The proximal end of the catheter projects over the chest in the subcutaneous tissues, and the connector hubs may or may not be visible depending on how they have been moved to acquire the radiograph. 

Indications

• chemotherapy administration ²
• parenteral nutrition ²
• long-term parenteral antibiotic administration ²

Complications

Insertion

• arrhythmia (most common) ¹
• arterial injury
• kinking
• pneumothorax
• failure

Long-term

• infection (most common) ^1,2
• occlusion, commonly due to fibrin sheath formation
• thrombosis
• tip migration

History and etymology

In the late 1970s, Robert O Hickman (1926-2019) ⁴, was a Fellow in pediatric nephrology, at the University of Washington in Seattle. He was asked by the bone marrow transplant nurses to create a new catheter for their patients. He modified the then widely-used Broviac catheter to create the Hickman catheter. The only difference was one of size, at that time the Broviac catheter was a 6.5 French gauge (Fr) catheter, whilst the original Hickman catheter was 9.6 Fr ³.