A Single-Incision Technique for Placement of Implantable Venous Access Ports via the Axillary Vein

Seo, Tae Seok; Song, Myung Gyu; Kang, Eun Young; Lee, Changhee; Yong, Hwan Seok; Doo, Kyungwon

doi:10.1016/j.jvir.2013.12.571

Cited by 28 publications

(36 citation statements)

References 20 publications

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“…Due to the continuity of the right internal jugular vein with the superior vena cava and right atrium, the possibility of catheter malposition is significantly reduced. Although there have been some studies describing the single-incision techniques for the VPC placement, complications including the arterial puncture, vein thrombosis, and a malpositioned guide wire were also described [20]. Contrary to these findings, we found no such complications in the ultrasound-guided technique via the right internal jugular vein.…”

Section: Discussioncontrasting

confidence: 82%

The comparison of intra-operative ultrasonography guidance with open surgical method for venous port catheter placement for chemotherapy

Balkanay¹,

Demiryas

2018

North Clin Istanbul

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OBJECTIVE:One of the leading venous access methods in chemotherapy is the use of a venous port catheter (VPC). An open surgical or ultrasound-guided technique can be performed. In our study, the VPC placement via both of these techniques was compared.METHODS:A total of 180 consecutive patients who underwent the VPC placement procedure either via the open or ultrasound-guided methods in two centers between January 2014 and January 2016 were included in the study. Patients’ data were reviewed retrospectively. Groups were compared in terms of intervention-related complication rates, a total procedure time, and the requirement of control imaging with ionizing radiation.RESULTS:The mean total procedure time was significantly shorter (19.5±4.6 min, 46.7±19.6 min, p<0.001) in the ultrasound-guided group than the open method. The rate of catheter malposition was significantly less in the ultrasound-guided group than in the open group (p<0.001). The need for per-operative imaging with ionizing radiation and the need of reversion in the preferred technique were not observed in the ultrasound-guided group, whereas in the open group, they were observed in 90 (100%) and 6 (6.7%) patients, respectively (p<0.001, p=0.01).CONCLUSION:Intraoperative ultrasound guidance for the VPC placement shortens the processing time and eliminates the need for routine imaging methods that require the use of ionizing radiation. In accordance with the current guidelines recommendations, intraoperative ultrasonography should be preferred as much as possible during the VPC placement. However, the need for the surgical teams in centers to maintain the necessary educational processes for both techniques should not be overlooked.

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Section: Discussioncontrasting

confidence: 82%

The comparison of intra-operative ultrasonography guidance with open surgical method for venous port catheter placement for chemotherapy

Balkanay¹,

Demiryas

2018

North Clin Istanbul

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“…All TIVAPs were inserted using the single incision technique reported by Seo et al (11) via the axillary vein. Before the procedure, the state of the brachiocephalic vein and superior vena cava was evaluated on a chest computed tomography (CT) scan if available.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of Symptomatic Axillary Vein Thrombosis After Placement of Totally Implanted Venous Access Port in Cancer Patients

2020

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Background: The incidence of venous thrombosis based on access route after implantation of the totally implanted venous access port (TIVAP) is controversial. Symptomatic TIVAP-related venous thrombosis remains relatively rare. However, characteristics of symptomatic axillary vein thrombosis after TIVAP implantation via access of the axillary vein has not been reported. Objectives: In this historical cohort study, the incidence and characteristics of venous thrombosis associated with TIVAP via the axillary vein in cancer patients were evaluated. Patients and Methods: A total of 4,773 TIVAPs were placed via the axillary vein in patients with various types of cancer between May 2012 and July 2018. Eighteen patients experienced symptomatic venous thrombosis associated with TIVAPs. Radiologic findings for venous thrombosis were evaluated using computed tomography (CT) including scans of the axillary vein. Medical records were retrospectively reviewed. Results: The prevalence of symptomatic thrombosis was 0.38% (18/4,773). The patients with symptomatic venous thrombosis included 14 males and four females. Among the 18 patients, the most common types of cancer were lung cancer (n = 7) and pancreatic cancer (n = 4), with the incidence rates of 0.79% (lung cancer, 7/882) and 1.58% (pancreatic cancer, 4/253), respectively. The median time between placement of the TIVAP and diagnosis of thrombosis was 35.5 days (range: 6 - 292 days). All symptomatic patients had thrombosis in the axillary vein on CT images. Symptoms were improved in all patients with treatment including removal of TIVAP at the time of diagnosis and following anticoagulation therapy. From the multiple binary logistic regression, pancreatic cancer and lung cancer were statistically significant risk factors of symptomatic axillary vein thrombosis. Conclusion: After insertion of TIVAPs through the axillary vein, symptomatic axillary vein thrombosis rarely developed. Pancreatic cancer and lung cancer were associated with the risk of symptomatic axillary vein thrombosis.

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“…Additionally, compared with Hickman catheters, we also detect a trend for lower risk of VTE in the TIVAP groups (OR = 0.75, 95% CI: 0.37-1.50), but the result was not significant (P = .413). The results were Preferred venous access site Upper-extremity vein 7,19,20,25,30,31,41,42,59,64,67,69,91 3 .029…”

Section: The Ors Of Tivap-associated Vtementioning

confidence: 99%

“…Retrospective 7,19,20,25,30,31,33,38,39,41,42,45,50,52,54,56,57,59,61,64 Port sites Chest ports 19,24,31,33,34,36,38,39,42,48,[50][51][52][53][54]57,61,64,68,[73][74][75][76] .702…”

Section: The Ors Of Tivap-associated Vtementioning

confidence: 99%

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Risk of venous thromboembolism associated with totally implantable venous access ports in cancer patients: A systematic review and meta‐analysis

Jiang

Pan

et al. 2020

Journal of Thrombosis and Haemostasis

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Background Totally implantable venous access ports (TIVAPs) for chemotherapy are associated with venous thromboembolism (VTE). We aimed to quantify the incidence of TIVAP‐associated VTE and compare it with external central venous catheters (CVCs) in cancer patients through a meta‐analysis. Methods Studies reporting on VTE risk associated with TIVAP were retrieved from medical literature databases. In publications without a comparison group, the pooled incidence of TIVAP‐related VTE was calculated. For studies comparing TIVAPs with external CVCs, odds ratios (ORs) were calculated to assess the risk of VTE. Results In total, 80 studies (11 with a comparison group and 69 without) including 39 148 patients were retrieved. In the noncomparison studies, the overall symptomatic VTE incidence was 2.76% (95% confidence interval [CI]: 2.24‐3.28), and 0.08 (95 CI: 0.06‐0.10) per 1000 catheter‐days. This risk was highest when TIVAPs were inserted via the upper‐extremity vein (3.54%, 95% CI: 2.94‐4.76). Our meta‐analysis of the case‐control studies showed that TIVAPs were associated with a decreased risk of VTE compared with peripherally inserted central catheters (OR = 0.20, 95% CI: 0.09‐0.43), and a trend for lower VTE risk compared with Hickman catheters (OR = 0.75, 95% CI: 0.37‐1.50). Meta‐regression models suggested that regional difference may significantly impact on the incidence of VTE associated with TIVAPs. Conclusions Current evidence suggests that the cancer patients with TIVAP are less likely to develop VTE compared with external CVCs. This should be considered when choosing the indwelling intravenous device for chemotherapy. However, more attention should be paid when choosing upper‐extremity veins as the insertion site.

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A Single-Incision Technique for Placement of Implantable Venous Access Ports via the Axillary Vein

Cited by 28 publications

References 20 publications

The comparison of intra-operative ultrasonography guidance with open surgical method for venous port catheter placement for chemotherapy

The comparison of intra-operative ultrasonography guidance with open surgical method for venous port catheter placement for chemotherapy

Characteristics of Symptomatic Axillary Vein Thrombosis After Placement of Totally Implanted Venous Access Port in Cancer Patients

Risk of venous thromboembolism associated with totally implantable venous access ports in cancer patients: A systematic review and meta‐analysis

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