Comparison of subcutaneous central venous port via jugular and subclavian access in 347 patients at a single center

Aribaş,Bilgin  Kadri; Arda,Kemal; Aribaş,Özge; Çiledağ,Nazan; Yoloğlu,Zeynel; Aktaş,Elif; Seber,Turgut; Kavak,Şeyhmus; Coşar,Yusuf; Kaygusuz,Hidir; Tekin,Ekrem

doi:10.3892/etm.2012.649

Comparison of subcutaneous central venous port via jugular and subclavian access in 347 patients at a single center

Authors:
- Bilgin Kadri Aribaş
- Kemal Arda
- Özge Aribaş
- Nazan Çiledağ
- Zeynel Yoloğlu
- Elif Aktaş
- Turgut Seber
- Şeyhmus Kavak
- Yusuf Coşar
- Hidir Kaygusuz
- Ekrem Tekin
View Affiliations

Affiliations: Department of Radiology, A. Y. Ankara Oncology Education and Research Hospital, Ankara 06200, Turkey, Department of Mathematics, Faculty of Science, University of Ankara, Tandoğan, Ankara 06100, Turkey
Published online on: July 30, 2012 https://doi.org/10.3892/etm.2012.649
Pages: 675-680

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The purpose of the present study was to examine whether patency times, including complications of subcutaneous venous chest port insertion using ultrasonography (US) guidance, differ between jugular and subclavian venous access. Between December 2008 and July 2010, subcutaneous venous chest ports were placed in 347 patients by an experienced team. All single-lumen port catheters were placed into jugular and subclavian veins under US and fluoroscopy guidance. Patency times and complication rates of ports via these routes were compared and the variables were age, gender, access, site of malignancy and coagulation parameters. The success of the jugular and subclavian groups was compared by univariate Kaplan-Meier survival analysis and the multivariable Cox regression test. A total of 15 patients underwent port removal due to complications. As a rate per 100 catheter days, ports were explanted in 7 (0.0092) due to thrombosis, 4 (0.0053) for catheter malposition, one each (0.0013) of port reservoir flip-over, bleeding, port pocket infection, skin necrosis and incision dehiscence, for a total of 15 patients (0.0197). Patency times were not different in the jugular and subclavian veins. Factors were not significant, with the exception of platelet count. There was no significant difference in patency times, including complications, between jugular vein access and subclavian vein access using US. This should be considered when selecting the access method.

View Figures

View References

1	Lorch H, Zwaan M, Kagel C and Weiss HD: Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol. 24:180–184. 2001. View Article : Google Scholar
2	Caers J, Fontaine C, Vinh-Hung V, et al: Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support Care Cancer. 13:325–331. 2005. View Article : Google Scholar : PubMed/NCBI
3	Plumhans C, Mahnken AH, Ocklenburg C, et al: Jugular versus subclavian totally implantable access ports: catheter position, complications and intrainterventional pain perception. Eur J Radiol. 79:338–342. 2011. View Article : Google Scholar
4	Cil BE, Canyiğit M, Peynircioğlu B, et al: Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol. 12:93–98. 2006.PubMed/NCBI
5	Lewis CA, Allen TE, Burke DR, et al: Society of Interventional Radiology Standards of Practice Committee: Quality improvement guidelines for central venous access. J Vasc Interv Radiol. 14:S231–S235. 2003.
6	Yip D and Funaki B: Subcutaneous chest ports via the internal jugular vein. A retrospective study of 117 oncology patients. Acta Radiol. 43:371–375. 2002. View Article : Google Scholar : PubMed/NCBI
7	Biffi R, Corrado F, de Braud F, et al: Long-term, totally implantable central venous access ports connected to a Groshong catheter for chemotherapy of solid tumours: experience from 178 cases using a single type of device. Eur J Cancer. 33:1190–1194. 1997. View Article : Google Scholar
8	Funaki B, Szymski GX, Hackworth CA, et al: Radiologic placement of subcutaneous infusion chest ports for long-term central venous access. AJR Am J Roentgenol. 169:1431–1434. 1997. View Article : Google Scholar : PubMed/NCBI
9	McGee DC and Gould MK: Preventing complications of central venous catheterization. N Engl J Med. 348:1123–1133. 2003. View Article : Google Scholar : PubMed/NCBI
10	Hind D, Calvert N, McWilliams R, et al: Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ. 327:3612003. View Article : Google Scholar : PubMed/NCBI
11	Biffi R, Orsi F, Pozzi S, et al: Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial. Ann Oncol. 20:935–940. 2009. View Article : Google Scholar : PubMed/NCBI
12	Di Carlo I, Pulvirenti E, Mannino M and Toro A: Increased use of percutaneous technique for totally implantable venous access devices. Is it real progress? A 27-year comprehensive review on early complications. Ann Surg Oncol. 17:1649–1656. 2010.PubMed/NCBI
13	Karakitsos D, Labropoulos N, De Groot E, et al: Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care. 10:R1622006. View Article : Google Scholar : PubMed/NCBI
14	Akahane A, Sone M, Ehara S, Kato K, Tanaka R and Nakasato T: Subclavian vein versus arm vein for totally implantable central venous port for patients with head and neck cancer: a retrospective comparative analysis. Cardiovasc Intervent Radiol. 34:1222–1229. 2011. View Article : Google Scholar : PubMed/NCBI
15	Sakamoto N, Arai Y, Takeuchi Y, Takahashi M, Tsurusaki M and Sugimura K: Ultrasound-guided radiological placement of central venous port via the subclavian vein: a retrospective analysis of 500 cases at a single institute. Cardiovasc Intervent Radiol. 33:989–994. 2010. View Article : Google Scholar : PubMed/NCBI
16	Teichgräber UK, Kausche S, Nagel SN and Gebauer B: Outcome analysis in 3,160 implantations of radiologically guided placements of totally implantable central venous port systems. Eur Radiol. 21:1224–1232. 2011.
17	Shetty PC, Mody MK, Kastan DJ, Sharma RP, Burke MW and Venugopal C: Outcome of 350 implanted chest ports placed by interventional radiologists. J Vasc Interv Radiol. 8:991–995. 1997. View Article : Google Scholar : PubMed/NCBI
18	Brooks AJ, Alfredson M, Pettigrew B and Morris DL: Ultrasound-guided insertion of subclavian venous access ports. Ann R Coll Surg Engl. 87:25–27. 2005. View Article : Google Scholar : PubMed/NCBI
19	McNulty NJ, Perrich KD, Silas AM, Linville RM and Forauer AR: Implantable subcutaneous venous access devices: is port fixation necessary? A review of 534 cases. Cardiovasc Intervent Radiol. 33:751–755. 2010. View Article : Google Scholar : PubMed/NCBI
20	de Costa BR, Dickey K and Greenwood L: A practical approach for repositioning flipped venous access ports. J Vasc Interv Radiol. 11:213–214. 2000.PubMed/NCBI
21	Ozdemir NY, Abali H, Oksuzoğlu B, Budakoglu B, Akmangit I and Zengin N: It appears to be safe to start chemotherapy on the day of implantation through subcutaneous venous port catheters in inpatient setting. Support Care Cancer. 17:399–403. 2009. View Article : Google Scholar : PubMed/NCBI
22	Trerotola SO, Kuhn-Fulton J, Johnson MS, Shah H, Ambrosius WT and Kneebone PH: Tunneled infusion catheters: increased incidence of symptomatic venous thrombosis after subclavian versus internal jugular venous access. Radiology. 217:89–93. 2000. View Article : Google Scholar
23	Silberzweig JE, Sacks D, Khorsandi AS and Bakal CW; Society of Interventional Radiology Technology Assessment Committee: Reporting standards for central venous access. J Vasc Interv Radiol. 14:S443–S452. 2003. View Article : Google Scholar : PubMed/NCBI