A Comparison of Internal Jugular versus Subclavian Vein Approaches in Totally Implanted Venous Access Ports
Year 2023,
Volume: 10 Issue: 2, 78 - 83, 21.08.2023
Murat Dökdök
,
Kutlay Karaman
,
Aysen Yucel
Abstract
The purpose of this study was to retrospectively review the outcome and complications of totally implantable venous-access ports (TIVAPs) inserted via low internal jugular vein (IJV) approach under ultrasound guidance versus subclavian vein (SCV) approach.304 cancer patients who could be followed up to the time of catheter removal or to the end of the study period were enrolled in the study. 200patients had the placement of TIVAPs via IJV and 104 patients via SCV. Statistical analysis showed that there were no differences with regard to the patient characteristics and to the site of primary malignancy in two groups, while the large majority of the TIVAPs had been inserted in the right side. The average port dwelling time was higher in the IJV group compared to the SCV group, the difference was statistically significant (p<0.001). Complications were more frequent in the SCV than in the IJV approach (12 patients vs. 3 patients). Our analysis revealed that TIVAP is a safe and effective route for long-term administration of chemotherapy, and the placement of TIVAPs via the right IJV is associated with a low long-term complication rate.
References
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- 2. Minassian VA, Sood AK, Lowe P, et al. Longterm central venous access in gynecologic cancer patients. J Am Coll Surg. 2000;191:403–9.
- 3. Ignatov A, Hoffman O,Smith B, et al. An 11-year retrospective study of totally implanted central venous access ports: Complications and patient satisfaction. Eur J Surg Oncol. 2009;35:241-6.
- 4. Cil BE, Canyiğit M, Peynircioğlu B, et al. Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol. 2006;12:93-8.
- 5. Lebeaux D, Fernández-Hidalgo N, Chauhan A, et al. Management of infections related to totally implantable venous-access ports: challenges and perspectives. Lancet Infect Dis. 2014;14:146-59.
- 6. Beckers MM, Ruven HJ, Seldenrijk CA, et al. Risk of thrombosis and infections of central venous catheters and totally implanted access ports in patients treated for cancer. Thromb Res. 2010;125:318-21.
- 7. Biffi R, Pozzi S, Agazzi A, et al. Use of totally implantable central venous access ports for high-dose chemotherapy and peripheral blood stem cell transplantation: results of a monocentre series of 376 patients. Ann Oncol. 2004;15:296–300.
- 8. Morris SL, Jacques PF, Mauro MA. Radiology assisted placement of implantable subcutaneous infusion ports for longterm venous access. Radiology.1992;184:149-51
- 9. Randolph AG, Cook DJ, Gonzales CA, et al. Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature. Crit Care Med. 1996;24:2053-8.
- 10. Saugel B, Scheeren TWL, Teboul JL. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care. 2017;21:225.
- 11. Brass P, Hellmich M, Kolodziej L, et al. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database Syst Rev. 2015;1(1):CD006962.
- 12. 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. 2009;20(5):935-40.
- 13. Brass P, Hellmich M, Kolodziej L, et al. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev. 2015;1(1):CD011447.
- 14. Biffi R, Corrado F, Braud F, et al. Longterm, 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. 1997;33:1190-4.
- 15. Macdonald S, Watt AJ, McNally D, et al. Comparison of technical success and outcome of tunneled catheters inserted via the jugular and subclavian approaches. J Vasc Interv Radiol. 2000;11:225-31.
- 16. Yip D and Funaki B: Subcutaneous chest ports via the internal jugular vein. A retrospective study of 117 oncology patients. Acta Radiol. 2002;43:371-5.
- 17. 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. 2011;79:338-42.
- 18. Cimochowski CE, Worley E, Rytherford WE, et al. Superiority of internal jugular over subclavian access for temporary dialysis. Nephron. 1990;54:154-61.
- 19. Lorch H, Zwaan M, Kagel C, et al. Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol. 2001;24:180-4.
- 20. Silberzweig J, Mitty HA. Central venous access: Low internal jugular vein approach using imaging guidance American Journal of Roentgenology. 1998;170(6):1617-20.
- 21. Park HS, Kim YI, Lee SH, et al. Central venous infusion port inserted via high versus low jugular venous approaches: Retrospective comparison of outcome and complications. Eur J Radiol. 2009;72(3): 494-8.
- 22. McGrath BA. Low internal jugular puncture sites when using ultrasound guidance. British Journal of Anaesthesia. 2008;(101).
- 23. Kowalski CM, Kaufman JA, Rivitz SM, et al. Migration of central venous catheters: Implications for initial catheter tip positioning. J Vasc Interv Radiol. 1997;8:443-7.
- 24. Puel V, Cuadry M, LeMetayer P, et al. Superior vena cava thrombosis related to catheter malposition in cancer chemotherapy given through implanted ports. Cancer. 1993;72:2248–52.
- 25. Schillinger F, Schillinger D, Montagrac R, et al. Central venous stenosis in hemodialysis: comparative angiographic study of subclavian and internal jugular access. Nephrologie. 1994;15:129-31.
- 26. Lee AY, Levine MN, Butler G, et al. Incidence, risk factors, and outcomes of catheter-related thrombosis in adult patients with cancer. J Clin Oncol. 2006;24:1404-9.
- 27. Semba CP, Weck S, Razavi MK, et al. Characterization of alteplase (tPA) following delivery through the AngioJet rheolytic catheter. J Endovasc Ther. 2005;12:123-8.
- 28. Crisinel M, Mahy S, Ortega-Debalon P, et al. Incidence, prevalence and risk factors for a first infectious complication on a totally implantable venous-access port. Med Mal Infect. 2009;39:252-8.
- 29. Estes JM, Rocconi R, Straughn M, et al. Complications of indwelling venous access devices in patients with gynecologic malignancies. Gynecol. Oncol. 2003;91:591-5.
- 30. Machat S, Eisenhuber E, Pfarl G, et al. Complications of central venous port systems: a pictorial review. Insights Imaging. 2019;10(1):86.
- 31. Chang HM, Hsieh CB, Hsieh HF, et al. An alternative technique for totally implantable central venous access devices. A retrospective study of 1311 cases. Eur J Surg Oncol. 2006;32:90-3.
- 32. Araújo C1, Silva JP, Antunes P, et al. A comparative study between two central veins for the introduction of totally implantable venous access devices in 1201 cancer patients. Eur J Surg Oncol. 2008;34:222-6.
Total İmplante Venöz Erişim Portlarında İnternal Juguler ve Subklavian Ven Yaklaşımlarının Karşılaştırılması
Year 2023,
Volume: 10 Issue: 2, 78 - 83, 21.08.2023
Murat Dökdök
,
Kutlay Karaman
,
Aysen Yucel
Abstract
Bu çalışmanın amacı, subklavyan ven (SCV) yaklaşımına karşı ultrason rehberliğinde düşük internal juguler ven (IJV) yaklaşımı ile yerleştirilen tamamen implante edilebilir venöz erişim portlarının (TIVAP'ler) sonuçlarını ve komplikasyonlarını geriye dönük olarak gözden geçirmektir. Kateter çıkarılıncaya veya çalışma süresinin sonuna kadar izlenebilen 304 kanser hastası çalışmaya alındı. 200 hastaya IJV yoluyla TIVAP ve 104 hastaya SCV yoluyla TIVAP yerleştirildi. İstatistiksel analizler hasta özellikleri ve primer malignite bölgesi açısından iki grupta fark olmadığını gösterdi, TIVAP'lerin büyük çoğunluğu sağ tarafa yerleştirilmişti. Ortalama port kalma süresi SCV grubuna kıyasla IJV grubunda daha yüksekti, bu fark istatistiksel olarak anlamlıydı (p<0.001). SCV'de komplikasyonlar IJV yaklaşımına göre daha sıktı (12 hastaya karşı 3 hasta). Çalışmamız, TIVAP'ın uzun süreli kemoterapi uygulaması için güvenli ve etkili bir yol olduğunu ve TIVAP'lerin doğru IJV yoluyla yerleştirilmesinin düşük uzun dönem komplikasyon oranı ile ilişkili olduğunu ortaya koydu.
References
- 1. Bow EJ, Kilpatrick MG, Clinch JJ. Totally implantable venous access ports systems for patients receiving chemotherapy for solid tissue malignancies:a randomized controlled clinical trial examining the safety, efficacy, costs, and impact on quality of life. J Clin Oncol. 1999;17:1267.
- 2. Minassian VA, Sood AK, Lowe P, et al. Longterm central venous access in gynecologic cancer patients. J Am Coll Surg. 2000;191:403–9.
- 3. Ignatov A, Hoffman O,Smith B, et al. An 11-year retrospective study of totally implanted central venous access ports: Complications and patient satisfaction. Eur J Surg Oncol. 2009;35:241-6.
- 4. Cil BE, Canyiğit M, Peynircioğlu B, et al. Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol. 2006;12:93-8.
- 5. Lebeaux D, Fernández-Hidalgo N, Chauhan A, et al. Management of infections related to totally implantable venous-access ports: challenges and perspectives. Lancet Infect Dis. 2014;14:146-59.
- 6. Beckers MM, Ruven HJ, Seldenrijk CA, et al. Risk of thrombosis and infections of central venous catheters and totally implanted access ports in patients treated for cancer. Thromb Res. 2010;125:318-21.
- 7. Biffi R, Pozzi S, Agazzi A, et al. Use of totally implantable central venous access ports for high-dose chemotherapy and peripheral blood stem cell transplantation: results of a monocentre series of 376 patients. Ann Oncol. 2004;15:296–300.
- 8. Morris SL, Jacques PF, Mauro MA. Radiology assisted placement of implantable subcutaneous infusion ports for longterm venous access. Radiology.1992;184:149-51
- 9. Randolph AG, Cook DJ, Gonzales CA, et al. Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature. Crit Care Med. 1996;24:2053-8.
- 10. Saugel B, Scheeren TWL, Teboul JL. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care. 2017;21:225.
- 11. Brass P, Hellmich M, Kolodziej L, et al. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database Syst Rev. 2015;1(1):CD006962.
- 12. 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. 2009;20(5):935-40.
- 13. Brass P, Hellmich M, Kolodziej L, et al. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev. 2015;1(1):CD011447.
- 14. Biffi R, Corrado F, Braud F, et al. Longterm, 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. 1997;33:1190-4.
- 15. Macdonald S, Watt AJ, McNally D, et al. Comparison of technical success and outcome of tunneled catheters inserted via the jugular and subclavian approaches. J Vasc Interv Radiol. 2000;11:225-31.
- 16. Yip D and Funaki B: Subcutaneous chest ports via the internal jugular vein. A retrospective study of 117 oncology patients. Acta Radiol. 2002;43:371-5.
- 17. 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. 2011;79:338-42.
- 18. Cimochowski CE, Worley E, Rytherford WE, et al. Superiority of internal jugular over subclavian access for temporary dialysis. Nephron. 1990;54:154-61.
- 19. Lorch H, Zwaan M, Kagel C, et al. Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol. 2001;24:180-4.
- 20. Silberzweig J, Mitty HA. Central venous access: Low internal jugular vein approach using imaging guidance American Journal of Roentgenology. 1998;170(6):1617-20.
- 21. Park HS, Kim YI, Lee SH, et al. Central venous infusion port inserted via high versus low jugular venous approaches: Retrospective comparison of outcome and complications. Eur J Radiol. 2009;72(3): 494-8.
- 22. McGrath BA. Low internal jugular puncture sites when using ultrasound guidance. British Journal of Anaesthesia. 2008;(101).
- 23. Kowalski CM, Kaufman JA, Rivitz SM, et al. Migration of central venous catheters: Implications for initial catheter tip positioning. J Vasc Interv Radiol. 1997;8:443-7.
- 24. Puel V, Cuadry M, LeMetayer P, et al. Superior vena cava thrombosis related to catheter malposition in cancer chemotherapy given through implanted ports. Cancer. 1993;72:2248–52.
- 25. Schillinger F, Schillinger D, Montagrac R, et al. Central venous stenosis in hemodialysis: comparative angiographic study of subclavian and internal jugular access. Nephrologie. 1994;15:129-31.
- 26. Lee AY, Levine MN, Butler G, et al. Incidence, risk factors, and outcomes of catheter-related thrombosis in adult patients with cancer. J Clin Oncol. 2006;24:1404-9.
- 27. Semba CP, Weck S, Razavi MK, et al. Characterization of alteplase (tPA) following delivery through the AngioJet rheolytic catheter. J Endovasc Ther. 2005;12:123-8.
- 28. Crisinel M, Mahy S, Ortega-Debalon P, et al. Incidence, prevalence and risk factors for a first infectious complication on a totally implantable venous-access port. Med Mal Infect. 2009;39:252-8.
- 29. Estes JM, Rocconi R, Straughn M, et al. Complications of indwelling venous access devices in patients with gynecologic malignancies. Gynecol. Oncol. 2003;91:591-5.
- 30. Machat S, Eisenhuber E, Pfarl G, et al. Complications of central venous port systems: a pictorial review. Insights Imaging. 2019;10(1):86.
- 31. Chang HM, Hsieh CB, Hsieh HF, et al. An alternative technique for totally implantable central venous access devices. A retrospective study of 1311 cases. Eur J Surg Oncol. 2006;32:90-3.
- 32. Araújo C1, Silva JP, Antunes P, et al. A comparative study between two central veins for the introduction of totally implantable venous access devices in 1201 cancer patients. Eur J Surg Oncol. 2008;34:222-6.