J Korean Soc Radiol.  2010 Sep;63(3):217-220. 10.3348/jksr.2010.63.3.217.

Evaluation of the Necessity of Port Fixation in Central Venous Port Implantation

Affiliations
  • 1Department of Radiology, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea.
  • 2Department of Radiology, Aju University school of Medicine, Kyonggi-do, Korea. jaeikbae@naver.com

Abstract

PURPOSE: The technical success and complications were especially focused on and evaluated the need for fixation of a port under fluoroscopic guidance placement of the totally implantable central venous access ports for long term central venous access.
MATERIALS AND METHODS
Two hundred eighty nine consecutive patients (170 men, 119 women, mean age: 52-year-old) who underwent venous port implantation for the administration of chemotherapy were followed over a 1-month period. The procedures were performed in the angiographic suite by an interventional radiologist and all access was through the right jugular vein, except for the patients who had undergone a right mastectomy. The procedures were performed in the following order: 1) venous puncture, 2) making a pocket, 3) catheter tunneling, 4) port insertion, 5) catheter sizing, and 6) insertion. A port which was connected to the tunneled catheter was inserted into the minimally sized subcutaneous pocket with the aid of a small retractor. A follow-up was performed with medical records and chest radiographs. The follow-up period for evaluating the venous port ranged from 59 to 329 days (mean: 175 days).
RESULTS
The procedures performed to gain right jugular vein access were successful without difficulty in all cases. The 18 patients that underwent procedures to gain left jugular vein access encountered some difficulty upon insertion of a catheter into the SVC due to encountering the tortuous left brachiocephalic vein. No complications occurred during and immediately after the procedure. In one case the port chamber rotated within the subcutaneous pocket; however, no catheter migration or malfunction occurred.
CONCLUSION
If port insertion was followed by catheter insertion, the port chamber can be tightly implanted in the minimally sized pocket. This would avoid the need for fixation of the catheter to the port chamber leading into the pocket.


MeSH Terms

Brachiocephalic Veins
Catheters
Female
Follow-Up Studies
Humans
Jugular Veins
Male
Mastectomy
Medical Records
Punctures
Thorax

Reference

1. Brothers TE, von Moll LK, Niederhuber JE, Roberts JA, Walker-Andrew S, Ensminger WD. Experience with subcutaneous infusion ports in three hundred patients. Surg Gynecol Obstet. 1988; 166:295–301.
2. Kock HJ, Pietsch M, Krause U, Wilke H, Eigler FW. Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port system. World J Surg. 1998; 22:12–16.
3. Morris SL, Jaques PF, Mauro MA. Radiology assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology. 1992; 184:149–151.
4. Reeves AR, Seshadri R, Trerotola SO. Recent trends in central venous catheter placement: a comparison of interventional radiology with other specialties. J Vasc Interv Radiol. 2001; 12:1211–1214.
5. Fan C. Implantable port devices. In : Ray CE, editor. Central venous access. Philadelphia: Lippincott-Williams & Wilkins;2001. p. 63–72.
6. Kim TH, Lee YS. Placement of an Implantable Central Venous Access Device. J Korean Radiol Soc. 1998; 38:437–440.
7. Kim YH, Shin BS, Ahn M. Implantable Central Venous Port: Comparison between Interventional Radiological Procedure and Surgical Procedure. J Korean Surg Soc. 2004; 67:467–471.
8. Choi JY, Kim HY, Jung SE, Park KW, Kim WK. Inversion of Implantable Central Venous Port in Children: 2 cases report. J Korean Assoc Pediatr Surg. 2006; 12:17–23.
9. Na HI, Shim HJ, Kwak BK, Kim HJ, Lee YC. Fixation methods for implantable port chamber: comparative study using glue, self-stabilizing leg and suture fixations in rabbits. Korean J Radiol. 2004; 5:266–273.
10. Song WG, Jin GY, Han YM, Yu HC. Central Venous Catheterization: Comparison between Interventional Radiological Procedure and Blind Surgical Procedure. J Korean Radiol Soc. 2002; 47:467–472.
Full Text Links
  • JKSR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr