Clinical outcomes of totally implantable venous access port placement via the axillary vein in patients with head and neck malignancy

Hong, Sun; Seo, Tae-Seok; Song, Myung Gyu; Seol, Hae Young; Suh, Sang Il; Ryoo, Inseon

doi:10.1177/1129729818781270

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…In the present study, symptomatic venous thrombosis occurred in one patient (0.55%), which was the only major complication observed within 30 days after the procedure. The incidence of thrombosis was lower than that reported in previous studies (range: 0.67% -8.4%); it was also lower than the threshold suggested (6%) in quality improvement guidelines (8,9,23).…”

Section: Discussioncontrasting

confidence: 73%

“…Considering the low periprocedural complication rate and the absence of any major complications, the single-incision technique is similar in safety to the conventional technique. The incidence of catheter-related infection was 5.49% in this study; the incidences of catheter-related infection were reportedly 1.7% -8.8% in other studies (8,(15)(16)(17)(18)(19)(20). In the present study, catheter-related infections were noted in the late phase of the follow-up period, which might have been due to patient factors (e.g., weakened immune status of patients with malignant disease, ongoing chemotherapy, and comorbidities), rather than differences between the two techniques with respect to implantation of the TIVAP (11,20,21).…”

Section: Discussioncontrasting

confidence: 45%

“…To overcome the limitations of the conventional technique, a single-incision technique through the IJV, axillary vein, and subclavian vein has been used for TIVAP placement. The advantages of the single-incision technique include elimination of a second venotomy incision, reduction of bleeding risk, shortened procedure time, fewer infections related to the neck incision, esthetic advantages, and reduction of postoperative discomfort by avoiding the requirement for a neck dressing (4)(5)(6)(7)(8)14). The limitations of the single-incision technique via IJV are limited subcutaneous tunnel length based on needle length, a potentially inaccessible IJV depending on the patient's anatomy or available needle length, and difficulty in advancing devices with a hairpin-turn shape (6).…”

Section: Discussionmentioning

confidence: 99%

“…However, the conventional technique has several potential limitations associated with the creation of two incisions, such as a risk of bleeding, patient dissatisfaction associated with discomfort and esthetic disadvantages (5,6). To overcome these limitations, the single-incision technique for placing TIVAPs has been extensively tested since 2007 (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

Jang

Kwon

et al. 2020

Iran J Radiol

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Background: A totally implantable venous access port (TIVAP) is an essential component of care for oncology patients. Conventional placement of the TIVAP is performed through the internal jugular vein or the subclavian vein using a tunneled catheter, which involves creating two incisions. However, the conventional technique has several potential limitations. To address these limitations, a single-incision technique without a second incision or subcutaneous tunneling has been extensively tested since first being introduced by Glenn in 2007. Objectives: The purpose of this study was to evaluate the technical success, clinical outcomes, and complications of the single-incision technique for the placement of TIVAPs. Patients and Methods: Between January 2013 and June 2017, 182 TIVAPs were placed by a single-incision technique in 175 patients, including 79 men and 96 women (mean age, 62.4 years; range: 20 - 88 years). Electronic medical records were retrospectively reviewed to obtain patient data, outcomes, and complication rates. Results: A total of 40,594 catheter maintenance days (median, 221.9 days; range, 1 - 889 days) were recorded for 182 TIVAPs in 176 patients. Technical and clinical success rates were both 100%. A total of 25 complications (complication rate, 13.74%) occurred, including catheter occlusion (5.49%), catheter-related infection (5.49%), wound dehiscence (1.10%), catheter kinking (0.55%), venous thrombosis (0.55%), and extravasation during infusion (0.55%). Conclusion: The single-incision technique for TIVAP via the axillary vein was safe and efficient with high technical and clinical success rates. This new technique may be a good alternative to conventional techniques.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

Jang

Kwon

et al. 2020

Iran J Radiol

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“…Major issues related to intravenous port implantation include first attempt success rate [ 1 , 2 , 3 ] and peri-operative and late complications [ 4 , 5 , 6 , 7 ]. Several native vessels can be used as the entry vessel for chest port insertion, including the cephalic vein [ 2 , 3 ], deltoid branch of the thoracoacromial vein [ 8 ], the axillary vein [ 1 , 9 ], the internal jugular vein [ 3 ], the external jugular vein [ 2 ], the left brachiocephalic vein [ 10 , 11 ], and the subclavian vein [ 12 , 13 , 14 ]. However, different implantation methods are used for different target vessels and varying long-term results have been reported.…”

Section: Introductionmentioning

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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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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Clinical outcomes of totally implantable venous access port placement via the axillary vein in patients with head and neck malignancy

Abstract: These data indicate that totally implantable venous access port implantation via the axillary vein in patients with head and neck malignancy is safe and feasible, with a low axillary vein access-related complication rate.

Cited by 11 publications

References 26 publications

Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

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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