Comparison between Ultrasound-guided TIVAD via the right innominate vein and the right internal jugular vein approach

Abstract

Purpose: To compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to explore the advantages and disadvantages of the two approaches. Methods: Six hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed. Results: All patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P=0.020). The incidence of perioperative complications was 1.18% (4/339) and the long-term complications was 3.54% (12/339) in the right INV group. The incidence of perioperative complications was 1.43% (4/280) and the long-term complications was 3.93% (11/280) in the right INV group. There was no significant difference in the incidence of complications between the two groups (P=0.785，P=0.799, respectively). Conclusions: US-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.