Venous cutdown versus the Seldinger technique for placement of totally implantable venous access ports

Hsu, Charlie; Kwan, Gigi N. C.; Evans-Barns, Hannah; Rophael, John A.; Driel, Mieke van

doi:10.1002/14651858.cd008942.pub2

Cited by 29 publications

(22 citation statements)

References 17 publications

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“…Our updated meta-analysis supports the superiority of the primary open technique in the prevention of postoperative pneumothorax, as recently shown in the large multicentre PORTAS-3 trial [9]. This contradicts data from previous meta-analyses, published in 2014 and 2016 [7,8], that showed similar frequencies of pneumothorax in patients undergoing open cut-down and closed cannulation for TIVAP implantation.…”

Section: Failure Of the Primary Techniquesupporting

confidence: 44%

“…One of the strengths of this meta-analysis is its large sample size: six RCTs with a total number of 1831 patients. In contrast to the meta-analysis by Orci et al including the same number of RCTs with less than the half of patients (n = 772) and a recent Cochrane review [8], we excluded the study by Boldo et al [39], in which not only the subclavian vein but also the internal jugular vein was used for closed cannulation, but the specific vessel was not reported regarding event rates, so the trial population was too heterogeneous to meet our inclusion criteria. In contrast to previous meta-analyses, we have consequently pooled ITT data from primary studies, reflecting the practical clinical scenario.…”

Section: Failure Of the Primary Techniquementioning

confidence: 89%

“…Two meta-analyses published in 2014 and 2016 compared open cut-down of the cephalic vein with closed cannulation of the subclavian vein. Both showed that closed cannulation was superior to open cut-down in terms of primary success rate, while there was no significant difference between the two procedures regarding the occurrence of postoperative complications, especially pneumothorax [7,8]. The Cochrane metaanalysis stated that the comparison of pneumothorax was restricted due to the low numbers of events.…”

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of primary open versus closed cannulation strategy for totally implantable venous access port implantation

Klaiber

Probst

Hackbusch

et al. 2021

Langenbecks Arch Surg

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Background There is still no reference standard for the implantation of totally implantable venous access ports (TIVAPs). A recently published multicentre randomised controlled trial (RCT) revealed a significantly greater risk of pneumothorax after closed cannulation than after an open strategy. The aim of this meta-analysis was to provide an update of the available evidence for the safety and effectiveness of primary open versus closed cannulation strategy. Methods RCTs comparing outcomes of open cut-down of the cephalic vein and closed cannulation of the subclavian vein were sought systematically in MEDLINE, Web of Science and CENTRAL. The primary outcome was the occurrence of pneumothorax. A beta-binominal model was applied to combine the respective outcomes, and results are presented as odds ratios (OR) with 95% confidence interval (CI). Results Six RCTs with a total of 1831 patients were included in final analysis. Meta-analysis showed statistically significant superiority of the open cut-down technique regarding pneumothorax (OR 0.308, 95% CI 0.122 to 0.776), but a statistically significant higher failure of the primary technique for the open cut-down technique than for closed cannulation (OR 2.364, 95% CI 1.051 to 5.315). There were no significant differences between the two procedures regarding other morbidity endpoints. Conclusion This meta-analysis shows a general superiority of open cut-down of the cephalic vein over closed cannulation of the subclavian vein regarding the occurrence of pneumothorax. Open cut-down should be the first-line approach for TIVAP implantation. Closed cannulation should be performed with ultrasound as second-line procedure if the open technique fails. Systematic review registration PROSPERO CRD42013005180

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Section: Failure Of the Primary Techniquesupporting

confidence: 44%

Section: Failure Of the Primary Techniquementioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of primary open versus closed cannulation strategy for totally implantable venous access port implantation

Klaiber

Probst

Hackbusch

et al. 2021

Langenbecks Arch Surg

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“…Presently, the percutaneous puncture route is more commonly applied in clinical practice. The results of a systematic review show that the complications of the percutaneous puncture route are comparable to those after surgical incision, but the success rate of the percutaneous puncture route is higher[ 19 ]. The internal jugular vein, subclavian vein, basilic vein, and femoral vein can be selected for the percutaneous puncture route, and the literature reports that the internal jugular vein and subclavian vein are used most often[ 5 ].…”

Section: Clinical Questionsmentioning

confidence: 99%

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

Zhang

Chen

2020

WJG

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Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time. Advantages of ports include a simple nursing process, low risk of infection and embolism, and high patient comfort. In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications, the Chinese Research Hospital Association Digestive Tumor Committee, the Chinese Association of Upper Gastrointestinal Surgeons, the Chinese Gastric Cancer Association, and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nation-wide expert letter reviews and on-site seminars, and formulated an expert consensus of the operation guidelines.

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“…The currently used Seldinger technique is based on the principle of a guiding wire that enters into the vessel lumen. After an anatomical evaluation of a correct position, a special, dedicated sheath with a valve is inserted into the lumen, enabling easy access into the internal jugular vein and the subsequent structures [40,41,42,43]. A Swan-Ganz (S-G) catheter, basically not different from the prototype used by its inventors in 1970, is inserted via the internal jugular vein into the right atrium, ventricle, and pulmonary arteries.…”

Section: Introductionmentioning

confidence: 99%

Right Heart Catheterization—Background, Physiological Basics, and Clinical Implications

Kubiak

Ciarka

Biniecka

et al. 2019

JCM

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The idea of right heart catheterization (RHC) grew in the milieu of modern thinking about the cardiovascular system, influenced by the experiments of William Harvey, which were inspired by the treatises of Greek philosophers like Aristotle and Gallen, who made significant contributions to the subject. RHC was first discovered in the eighteenth century by William Hale and was subsequently systematically improved by outstanding experiments in the field of physiology, led by Cournand and Dickinson Richards, which finally resulted in the implementation of pulmonary artery catheters (PAC) into clinical practice by Jeremy Swan and William Ganz in the early 1970s. Despite its premature euphoric reception, some further analysis seemed not to share the early enthusiasm as far as the safety and effectiveness issues were concerned. Nonetheless, RHC kept its significant role in the diagnosis, prognostic evaluation, and decision-making of pulmonary hypertension and heart failure patients. Its role in the treatment of end-stage heart failure seems not to be fully understood, although it is promising. PAC-guided optimization of the treatment of patients with ventricular assist devices and its beneficial introduction into clinical practice remains a challenge for the near future.

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Venous cutdown versus the Seldinger technique for placement of totally implantable venous access ports

Abstract: Venous cutdown versus the Seldinger technique for placement of totally implantable venous access ports.

Cited by 29 publications

References 17 publications

Meta-analysis of primary open versus closed cannulation strategy for totally implantable venous access port implantation

Meta-analysis of primary open versus closed cannulation strategy for totally implantable venous access port implantation

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

Right Heart Catheterization—Background, Physiological Basics, and Clinical Implications

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