Cephalic Vein Cut-down for Totally Implantable Central Venous Access Devices With Preoperative Ultrasonography by Surgical Residents

Hashimoto, Shintaro; Otsubo, Ryota; Adachi, Masahiro; Doi, Ryoichiro; Shibata, Kenichiro; Sano, Isao; Shibata, Yoshihito; Nakazaki, Takayuki; Taniguchi, Hideki; Nagayasu, Takeshi

doi:10.21873/invivo.11707

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…Studying laterality, in most studies the rate is higher via RCV, both without (95.5%) 15 and with POUS (95.8%). 16 In this study the success rate via LCV was higher than that found via RCV, 98.5%, although not significantly.…”

Section: Discussioncontrasting

confidence: 53%

“…We have had 5.0% postoperative/delayed complications, while those observed in other studies range between 1.3% 18 and 15.7%. 17 System infection is the most concerning complication of the TIVAPs, as it usually requires explantation, and the figures range between 1.6% 16 and 10.8%. 19 In our case it was 1.6%, and the majority were due to puncture of the port by out-of-hospital personnel without adequate conditions.…”

Section: Discussionmentioning

confidence: 99%

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The Implantation of Totally Implantable Venus Access Ports Way: Cephalic Vein Cut-Down in Oncologycal Patients

Vélez¹

2021

SIOAJ

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Introduction: In an observational and retrospective study we wish to demonstrate that the performance of Preoperative Ultrasound prior to implantation of a Totally Implantable Venous Access Port (TIVAP) using Cephalic Vein Cut-down (CVC) improves the success rate and reduces complications. Method: Between 2008 and 2018, 860 Cephalic Veins (CV) were studied preoperatively with Ultrasound. The Cephalic Vein was not suitable with a diameter less than or equal to 3.3mm. Diameters, procedure times, success rate, follow-ups and complications were studied. Results: An Ultrasound was performed on 860CV, 146 (16.9%) were ruled out for implantation for various reasons. Of the 714CV to study, they belonged to 681 patients (63.3% women), with a mean age of 60.5 years (19-87). Age and colon neoplasia were significantly higher in males (p<0.001). Of the 714 valid cases, in 12 cases (1.7%) there was a spasm of the CV so that the overall success rate was 97.9%, being higher via the LCV (98.5%). The 85.2% were accessed using the Left Cephalic Vein (LCV). The mean diameter was 3.8±0.2mm and the mean procedure time was 25.0±2.6 minutes, being less via the LCV (p<0.02). There were no intraoperative complications, and 1.3% experienced postoperative complications, predominantly Deep Vein Thrombosis (0.8%). There were 26 delayed complications (3.7%), the most frequent being system infection (1.7%) and catheter occlusion (1.3%). 200 TIVAPs (28.6%) were explanted, 24.5% due to end of treatment, 3.2% due to complications and 0.9% due to other causes. Conclusion: The Cephalic Vein Cut-down whit preoperative ultrasound is an excellent via for the implantation of TIVAP with high rate the success, without intraoperative complications and with few postoperative complications.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

The Implantation of Totally Implantable Venus Access Ports Way: Cephalic Vein Cut-Down in Oncologycal Patients

Vélez¹

2021

SIOAJ

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“…In this study, we used the coracoid process of the scapula as a landmark for incision, thus minimizing incision variation [ 20 , 22 ]. In addition, vessel cutdown was the preferred method and the cephalic vein was the target vessel for port implantation because of its low complication rate [ 15 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

Wen

et al. 2021

JPM

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Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

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“…The rate of immediate complications with the percutaneous approach is near 0.05% [10,13,29]. In contrast, for the cut-down technique, the complication rate is nil [33,34,38]. Therefore, residents will have better success when they practice the cut-down technique.…”

Section: Discussionmentioning

confidence: 99%

“…US has also been used for investigating the status of the cephalic vein (their dimensions and deepness) [31,38]. This technique can be useful for the diagnosis of an anatomical absence of this vein.…”

Section: Discussionmentioning

confidence: 99%

Forty years after the first totally implantable venous access device (TIVAD) implant: the pure surgical cut-down technique only avoids immediate complications that can be fatal

Toro¹,

Schembari

Fontana

et al. 2021

Langenbecks Arch Surg

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Aim Even though TIVADs have been implanted for a long time, immediate complications are still occurring. The aim of this work was to review different techniques of placing TIVAD implants to evaluate the aetiology of immediate complications. Methods A systematic literature review was performed using the PubMed, Cochrane and Google Scholar databases in accordance with the PRISMA guidelines. The patient numbers, number of implanted devices, specialists involved, implant techniques, implant sites and immediate complication onsets were studied. Results Of the 1256 manuscripts reviewed, 36 were eligible for inclusion in the study, for a total of 17,388 patients with equivalent TIVAD implantation. A total of 2745 patients (15.8%) were treated with a surgical technique and 14,643 patients (84.2%) were treated with a percutaneous technique. Of the 2745 devices (15.8%) implanted by a surgical technique, 1721 devices (62.7%) were placed in the cephalic vein (CFV). Of the 14,643 implants (84.2%) placed with a percutaneous technique, 5784 devices (39.5%) were placed in the internal jugular vein (IJV), and 5321 devices (36.3%) were placed in the subclavian vein (SCV). The number of immediate complications in patients undergoing surgical techniques was 32 (1.2%) HMMs. In patients treated with a percutaneous technique, the number of total complications were 333 (2.8%): 71 PNX (0.5%), 2 HMT (0.01%), 175 accidental artery punctures AAP (1.2%) and 85 HMM (0.6%). No mortality was reported with either technique. Conclusion The percutaneous approach is currently the most commonly used technique to implant a TIVAD, but despite specialist’s best efforts, immediate complications are still occurring. Surgical cut-down, 40 years after the first implant, is still the only technique that can avoid all of the immediate complications that can be fatal.

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Cephalic Vein Cut-down for Totally Implantable Central Venous Access Devices With Preoperative Ultrasonography by Surgical Residents

Cited by 8 publications

References 20 publications

The Implantation of Totally Implantable Venus Access Ports Way: Cephalic Vein Cut-Down in Oncologycal Patients

The Implantation of Totally Implantable Venus Access Ports Way: Cephalic Vein Cut-Down in Oncologycal Patients

Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

Forty years after the first totally implantable venous access device (TIVAD) implant: the pure surgical cut-down technique only avoids immediate complications that can be fatal

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