Radiation exposure during insertion of totally implantable port vascular devices

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To evaluate the combination of access site and level of experience on fluoroscopy times (FT) and dose area products (DAP) during implantation of port catheters in a large patient population” Jonczyk et al (2017).

Abstract:

BACKGROUND: Totally implantable central venous port systems provide a safe and effective, long-term means of access for administration of hyperosmolar, local irritant medication, such as chemotherapy, antibiotics and parenteral nutrition.

AIM: To evaluate the combination of access site and level of experience on fluoroscopy times (FT) and dose area products (DAP) during implantation of port catheters in a large patient population.

MATERIALS AND METHODS: A total of 1,870 patients (992 women, 878 men; age: 61±13.14 years) were reviewed investigating two groups of junior (≤50 implantations) and senior (>50) radiologists.

RESULTS: Senior radiologists required less FT/DAP (0.24 s/57.3 μGy m2 versus 0.43 s/68.2 μGy m2, respectively; p<0.001). Right jugular vein access required the least FT/DAP (0.25 s/56.15 μGy m2) and right-sided implantation lower FT/DAP (right: 0.26 s/56.4 μGy m2, left: 0.40 s/85.10 μGy m2, p<0.001).

CONCLUSION: Due to DAP/FT reductions, the right jugular vein seems to be the most favorable implantation side for port systems. For further dose reduction, residents should be well-trained.

Reference:

Jonczyk, M., Gebauer, B., Rotzinger, R., Schnapauff, D., Hamm, B. and Collettini, F. (2018) Totally Implantable Central Venous Port Catheters: Radiation Exposure as a Function of Puncture Site and Operator Experience. In Vivo. 32(1), p.179-184.

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