Safety of a Totally Implantable Central Venous Port System with Percutaneous Subclavian Vein Access

Abstract

BackgroundThe role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method.Materials and MethodsBetween March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated.ResultsThere were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%).ConclusionSurgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.

Evaluation of three different techniques for insertion of totally implantable venous access device: A randomized clinical trial

“…Similar to our study, Keum et al analyzing only patients undergoing TIVAD implant through SCB found no intraoperative complications as well [2].…”

An unusual catheter malposition following totally implantable venous access port insertion: The catheter tip located into the right axillary vein

“…According to the large case series, the rate of catheter mispositioning following TIVAP insertion varies between 0.2% and 3.1% [2,[7][8][9][10][11][12][13][14][15][16][17] (Table 1). [16] 2018 3000 0.2% 9.6% Kim et al [17] 2019 843 0.3% 4%…”

“…It has been indicated that TIVAP insertion under imaging guidance reduces the procedure-related complication rates [18][19][20]. On the other hand, surgeons use either cut-down or percutaneous landmark-based technique for implantation, with low complication rates [2,[7][8][9][10][11][12][13][14][15][16][17]. Since we, the surgeons, are very familiar with blind-landmark technique as well as vascular anatomy of neck and chest regions, and also may recognize and treat the potential procedure-related complications quickly and properly, we applied the blindlandmark technique during TIVAP insertion but unfortunately observed this adverse event.…”

Comparison of the outcomes of the implanted subcutaneous ports in cancer patients: six-years single center experience

“…Keum et al reported a series with 242 patients who had 245 ports inserted via subclavian vein [10]. All ports were placed by a thoracic surgeon and no radiologic guidance was used.…”