Comparison between Internal Jugular and Upper Arm Peripheral Veins Approach in Insertion of Totally Implantable Central Venous Ports

Abstract

Objectives: To compare internal jugular vein approach and upper arm approach through basilic or cephalic veins in insertion of total implantable central venous port regarding early post-operative complications, patency rate, compliance and patient quality of life. Methods:We identified 50 patients who underwent totally implantable venous access ports (TIVAP) implantation in the arm (25 patients) or chest (25 patients) between November 2015 and November 2017. Implantation via an upper arm (cephalic or basilic) occurred through venous cut down, the internal jugular vein was performed using percutaneous technique. 1 All approaches were under fluoroscopic guidance. Early, postoperative complications were evaluated. During follow up, self-compliance and quality of life were assessed as well.Results: Technical success was 100%. Procedure-related arterial injury occurred in 3 patients in central approach only, post-operative hematoma or stitch inflammation and seroma were observed. Late complications included catheter infection, occlusion, pinch off syndrome and skin dehiscence. Thrompophlepities of the vein and extravasation in both techniques were documented and quality of life was assessed during follow up.Conclusions: Totally implantable venous access ports (TIVAP) can be implanted with high technical success rates, and are associated with low rates of complications. Upper arm implantation may benefit clinicians and patients with respect to safety and comfort.