Fluoroscopy-free ultrasound-guided port implantation
Abstract:
Materials and methods: This retrospective study included 2095 consecutive port implantations performed via the right internal jugular vein using a fluoroscopy-free technique at a high-volume oncology center. Catheter length was determined according to patient height. Procedural outcomes were assessed in the entire cohort. Clinical outcomes including catheter dysfunction, infection, port removal, and port dwell time were analyzed in 1524 patients with uninterrupted follow-up. Kaplan-Meier analysis was performed to evaluate port survival according to catheter tip position.
Results: Eleven procedures required intra-procedural conversion to fluoroscopy, corresponding to a conversion rate of 0.5%. Correct catheter tip localization was achieved in 98.5% of procedures. The overall catheter dysfunction rate was 2.95% and the infection rate was 4.46%. Infection was the most common reason for port removal. Kaplan-Meier analysis demonstrated no significant difference in port survival between accurately positioned and malpositioned catheter tips (log-rank p = 0.89).
Conclusion: Fluoroscopy-free port implantation using US-guidance combined with height-based catheter length estimation demonstrated high technical success and acceptable complication rates in this large retrospective cohort. Although this institutional protocol may represent a feasible alternative in selected settings, fluoroscopy-guided port placement remains a widely validated and guideline-supported approach.
Reference:
Bayrak A, Bilgin E, İmamoğlu Ç, Bilgin EY. Fluoroscopy-free ultrasound-guided port implantation using height-based catheter length estimation: A retrospective feasibility study of 2095 consecutive procedures. Clin Imaging. 2026 Apr 1;134:110793. doi: 10.1016/j.clinimag.2026.110793. Epub ahead of print. PMID: 41955763.