BACKGROUND: Totally implantable venous access ports (TIVAPs) are widely applied in patients who require chemotherapy, parenteral nutrition, or frequent intravenous drug infusion. Although various venous access routes are possible for TIVAP insertion, the best method remains a topic of controversy. We present a single center retrospective study of radiologically guided placement of TIVAPs through the basilic vein, with analysis of technical feasibility, patient safety, and device-related complications.
METHODS: We retrospectively reviewed 270 patients who received TIVAP implantation through the basilic vein from November 2013 to July 2016, under imaging guidance by an interventional radiology team at our institution. Fluoroscopic images, chest radiographs, computed tomography scans, and medical records were reviewed after port implantation. Catheter maintenance days were calculated and catheter related complications were recorded.
RESULTS: The procedural success rate was 99.3%. In total, 270 TIVAPs were implanted in 270 patients, of which 150 remained functional at the end of the study period. The total catheter maintenance days was 77543 days, and the mean catheter indwelling duration was 287 ± 207 days. In 20 (7.4%) patients, TIVAP-related complications occurred during the follow-up period, resulting in a post-procedural complication rate of 0.26incidences per 1000 catheter days. No significant relationship was observed between complications and gender (p = 0.188), age (p = 0.528), body mass index (p = 0.547), the type of primary malignancy (p=0.914), or between the left and right basilic veins (p = 0.319).
CONCLUSION: Real-time ultrasound and fluoroscopic guidance provides a safe method for TIVAP implantation through the basilic vein, with a high technical success rate and few device-related complications.Reference:
Kao, C.Y., Fu, C.H., Cheng, Y.C., Chen, J.L., Cheng, Y.C., Chen, C.C. and Chai, J.W. (2020) Outcome analysis in 270 radiologically guided implantations of totally implantable venous access ports via basilic vein. Journal of the Chinese Medical Association. January 22nd. doi: 10.1097/JCMA.0000000000000265. (Epub ahead of print).