Author's reply

EDITOR,--It is apparent that some of my statements have been misinterpreted: although interventional radiologists are best placed to insert permanent central venous catheters, there is no reason why other people should not be trained in this procedure. Nevertheless, it is important to acquire the appropriate skills in manipulating catheters: however “ingeniously designed,” catheters cannot find their own way.

Used with the imaging guided technique, coaxial systems that use 21-22 gauge needles to introduce catheters provide a greater margin of …