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Comparison between upper arm and chest for totally implanted venous access ports

To evaluate the safety, technical feasibility, and complications of totally implanted central venous access ports (TIVAPs) in the upper arm, for comparison with trans-jugular chest ports in patients with breast cancer” Yang and Ahn (2018).

Abstract:

BACKGROUND: To evaluate the safety, technical feasibility, and complications of totally implanted central venous access ports (TIVAPs) in the upper arm, for comparison with trans-jugular chest ports in patients with breast cancer.

METHODS: In total, 223 consecutive female breast cancer patients who received a TIVAP in the upper arm or chest between July 2014 and February 2016 were included. All procedures were performed via a sonographic and fluoroscopic-guided approach using the Seldinger technique under local anesthesia. We reviewed the medical records to determine technical success, pain scale, early (≤30 days), and late (>30 days) complications.

RESULTS: In total, 231 devices were implanted in the upper arms (n=176, 76%) and chests (n=55, 24%) of the patients. The mean age was 51.6±10.7 years (range 23-78 years; upper arm, 52.1±11.0 years; chest, 50.1±9.7 years, P>0.05). The mean implantation time for TIVAPs was 181.7±109.2 days (range, 9-460 days; upper arm 175.2±102.7 days; chest, 202.4±126.6 days, P>0.05), with 41,974 catheter-days. The technical success rate was 100%. Fourteen complications (6.1%) occurred in 14 patients (0.33/1000 catheter-days). There was no significant difference in complication-free survival for patients with upper arm TIVAPs and those with trans-jugular chest TIVAPs. The mean amount of 2% lidocaine, used as local anesthesia, was 3.3±1.7 ml and 14.5±4.1 ml for upper arm and chest TIVAPs, respectively. (P<0.001).

CONCLUSIONS: Implantation of TIVAPs in the upper arm is a safe procedure with a low rate of complications. Upper arm TIVAPs can be implanted with less pain compared with trans-jugular chest TIVAPs.

Reference:

Yang, S.S. and Ahn, M.S. (2018) A comparison between upper arm and chest for optimal site of totally implanted venous access ports in patients with female breast cancer. Annals of Vascular Surgery. February 23rd. .

doi: 10.1016/j.avsg.2017.11.059.

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