Randomized clinical trial comparing venous cutdown with the Seldinger technique for placement of implantable venous access ports

Nocito, Antonio; Wildi, Stephan M.; Rufibach, Kaspar; Clavien, Pierre‐Alain; Weber, Markus

doi:10.1002/bjs.6730

Cited by 65 publications

(57 citation statements)

References 24 publications

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“…Regarding implantation in the chest, the high rate of technical success in our study concurs with results from other trials reporting technical success rates between 71% and 100% [13,14]. Although it has been hypothesised that implantation via the subclavian vein results in a higher rate of pneumothorax than access via the internal jugular vein [1,15], we observed no cases of pneumothorax in our series.…”

Section: Discussionsupporting

confidence: 90%

Totally implantable venous power ports of the forearm and the chest: initial clinical experience with port devices approved for high-pressure injections

Goltz¹,

Noack²,

Petritsch³

et al. 2012

The British Journal of Radiology

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Objectives: To evaluate the technical success, clinical outcome and safety of percutaneously placed totally implantable venous power ports (TIVPPs) approved for high-pressure injections, and to analyse their value for arterial phase CT scans. Methods: Retrospectively, we identified 204 patients who underwent TIVPP implantation in the forearm (n5152) or chest (n552) between November 2009 and May 2011. Implantation via an upper arm (forearm port, FP) or subclavian vein (chest port, CP) was performed under sonographic and fluoroscopic guidance. Complications were evaluated following the standards of the Society of Interventional Radiology. Power injections via TIVPPs were analysed, focusing on adequate functioning and catheter's tip location after injection. Feasibility of automatic bolus triggering, peak injection pressure and arterial phase aortic enhancement were evaluated and compared with 50 patients who had had power injections via classic peripheral cannulas. Results: Technical success was 100%. Procedure-related complications were not observed. Catheter-related thrombosis was diagnosed in 15 of 152 FPs (9.9%, 0.02/100 catheter days) and in 1 of 52 CPs (1.9%, 0.002/100 catheter days) (p,0.05). Infectious complications were diagnosed in 9 of 152 FPs (5.9%, 0.014/100 catheter days) and in 2 of 52 CPs (3.8%, 0.003/100 catheter days) (p.0.05). Arterial bolus triggering succeeded in all attempts; the mean injection pressure was 213.8 psi. Aortic enhancement did not significantly differ between injections via cannulas and TIVPPs (p.0.05). Conclusions: TIVPPs can be implanted with high technical success rates, and are associated with low rates of complications if implanted with sonographic and fluoroscopic guidance. Power injections via TIVPPs are safe and result in satisfying arterial contrast. Conventional ports should be replaced by TIVPPs.

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Section: Discussionsupporting

confidence: 90%

Totally implantable venous power ports of the forearm and the chest: initial clinical experience with port devices approved for high-pressure injections

Goltz¹,

Noack²,

Petritsch³

et al. 2012

The British Journal of Radiology

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“…A TIVAP comprises a subcutaneously implanted port (or reservoir) connected to a central venous catheter, most frequently inserted into the internal jugular, subclavian, or cephalic vein [3]. TIVAP provides long-term central venous access and thus simplify the administration of chemotherapy and parenteral nutrition, as well as the repeated collection of blood samples [4]. Moreover, the TIVAP system has greatly improved the quality of life for patients with cancer, because it has enabled them to resume their normal daily activities while permitting a complete subcutaneous access [5].…”

Section: Introductionmentioning

confidence: 99%

Infections Related to Totally Implantable Venous-Access Ports: Long-Term Experience in One Center

Yang

Miao

et al. 2014

Cell Biochem Biophys

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The purpose of this study was to investigate the incidence and risk factors of infections associated with totally implantable venous-access ports (TIVAPs) in our hospital. From April 2007 through November 2013, a total of 1,026 patients with TIVAP were included in this study. We retrospectively analyzed the incidence of port-related infection, patient characteristics, and history. Risk factors for IVAP-related infection were determined statistically. Overall, 97 (9.59 %) of 1,026 infectious cases were reported. By reviewing the medical record of the patients, we found that younger age, hematogenous malignancy, and palliative chemotherapy were associated with higher infection incidence rate in patients who had implanted TIVAP (P < 0.05) in the subgroup analysis. In contrast, gender and insertion site were irrelevant factors in predicting the infection risk. Overall, TIVAP were proved to be safe and effective. Younger age, hematogenous malignancy, and palliative chemotherapy were associated with higher infection in patients who had implanted TIVAP.

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“…Port-A-Cath insertion is often performed via the subclavian vein (SCV). A number of studies have examined the complications associated with SCV catheterization and the use of port systems [1,2,3,4,5,6]; however, few studies to date have compared surgical and postoperative complications of right- versus left--SCV Port-A-Cath system insertion.…”

Section: Introductionmentioning

confidence: 99%

Right- and Left-Subclavian Vein Port-A-Cath Systems: Comparison of Complications

Tsai

Ku²,

Chen³

et al. 2012

Eur Surg Res

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Background: Central venous access systems are frequently used for delivery of medications; however, few studies have compared surgical and postoperative complications of right versus left access via the subclavian vein (SCV). The aim of this study was to compare the surgical and postoperative complications associated with Port-A-Cath system insertion via the right and left SCV. Methods: The medical records of patients who received Port-A-Cath insertion via the SCV for parenteral chemotherapy between August 2004 and July 2008 were reviewed. The incidence of surgical and postoperative complications was compared between patients who received right- versus left-SCV Port-A-Cath insertion. Results: A total of 1,848 patients were included in the study. Right-SCV catheterization was attempted in 1,029 (55.7%) patients and was successful in 866 (84.2%). Left-SCV catheterization was attempted in 819 (44.3%) patients and was successful in 651 (79.5%). The mean length of postoperative follow-up was 417.3 ± 401.3 and 396.7 ± 379.9 days for the right- and left-SCV groups, respectively. The incidence of SCV puncture failure was significantly lower in the right-SCV group (12.3%) compared with the left-SCV group (16.8%, p = 0.006). The incidence of catheter knotting at the ipsilateral brachiocephalic vein was also significantly lower in the right-SCV group (0.0%) compared with the left-SCV group (0.5%, p = 0.038), as was the incidence of catheter occlusion (1.0% for right SCV vs. 3.5% for left SCV, p = 0.001). Conclusion: These findings suggest that the right-SCV approach is superior to the left-SCV approach for Port-A-Cath insertion.

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Randomized clinical trial comparing venous cutdown with the Seldinger technique for placement of implantable venous access ports

Abstract: NCT00272623 (http://www.clinicaltrials.gov).

Cited by 65 publications

References 24 publications

Totally implantable venous power ports of the forearm and the chest: initial clinical experience with port devices approved for high-pressure injections

Totally implantable venous power ports of the forearm and the chest: initial clinical experience with port devices approved for high-pressure injections

Infections Related to Totally Implantable Venous-Access Ports: Long-Term Experience in One Center

Right- and Left-Subclavian Vein Port-A-Cath Systems: Comparison of Complications

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