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CardioVascular and Interventional Radiology

, Volume 33, Issue 5, pp 989–994 | Cite as

Ultrasound-Guided Radiological Placement of Central Venous Port via the Subclavian Vein: A Retrospective Analysis of 500 Cases at a Single Institute

  • Noriaki SakamotoEmail author
  • Yasuaki Arai
  • Yoshito Takeuchi
  • Masahide Takahashi
  • Masakatsu Tsurusaki
  • Kazuro Sugimura
Clinical Investigation

Abstract

The purpose of this study was to assess the technical success rate and adverse events (AEs) associated with ultrasound (US)-guided radiological placement (RP) of a central venous port (CVP) via the subclavian vein (SCV). Between April 2006 and May 2007, a total of 500 US-guided RPs of a CVP via the SCV were scheduled in 486 cancer patients (mean age ± SD, 54.1 ± 18.1 years) at our institute. Referring to the interventional radiology report database and patients’ records, technical success rate and AEs relevant to CVP placement were evaluated retrospectively. The technical success rate was 98.6% (493/500). AEs occurred in 26 cases (5.2%) during follow-up (range, 1–1080 days; mean ± SD, 304.0 ± 292.1 days). AEs within 24 h postprocedure occurred in five patients: pneumothorax (n = 2), arterial puncture (n = 1), hematoma formation at the pocket site (n = 2), and catheter tip migration into the internal mammary vein (n = 1). There were seven early AEs: hematoma formation at the pocket site (n = 2), fibrin sheath formation around the indwelling catheter (n = 2), and catheter-related infections (n = 3). There were 13 delayed AEs: catheter-related infections (n = 7), catheter detachments (n = 3), catheter occlusion (n = 1), symptomatic thrombus in the SCV (n = 1), and catheter migration (n = 1). No major AEs, such as procedure-related death, air embolism, or events requiring surgical intervention, were observed. In conclusion, US-guided RP of a CVP via the SCV is highly appropriate, based on its high technical success rate and the limited number of AEs.

Keywords

Central venous port Ultrasound Subclavian vein Venous access Indwelling catheter 

Notes

Acknowledgment

We wish to thank Ms. Onoe for her kind support in the preparation of the manuscript.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Morris SL, Jaques PF, Mauro MA (1992) Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access. Radiology 184(1):149–151PubMedGoogle Scholar
  2. 2.
    Funaki B, Szymski GX, Hackworth CA et al (1997) Radiologic placement of subcutaneous infusion chest ports for long-term central venous access. AJR 169(5):1431–1434PubMedGoogle Scholar
  3. 3.
    Shetty PC, Mody MK, Kastan DJ et al (1997) Outcome of 350 implanted chest ports placed by interventional radiologists. J Vasc Interv Radiol 8(6):991–995CrossRefPubMedGoogle Scholar
  4. 4.
    Simpson KR, Hovsepian DM, Picus D (1997) Interventional radiologic placement of chest wall ports: results and complications in 161 consecutive placements. J Vasc Interv Radiol 8(2):189–195CrossRefPubMedGoogle Scholar
  5. 5.
    Schwarz R, Groeger J, Coit D (1997) Subcutaneously implanted central venous access devices in cancer patients: a prospective analysis. Cancer 79(8):1635–1640CrossRefPubMedGoogle Scholar
  6. 6.
    Kock HJ, Pietsch M, Krause U et al (1998) Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port systems. World J Surg 22(1):12–16CrossRefPubMedGoogle Scholar
  7. 7.
    Biffi R, de Braud F, Orsi F et al (1998) Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 9(7):767–773CrossRefPubMedGoogle Scholar
  8. 8.
    Lorch H, Zwaan M, Kagel C et al (2001) Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. CardioVasc Interv Radiol 24(3):180–184CrossRefGoogle Scholar
  9. 9.
    Vardy J, Engelhardt K, Cox K et al (2004) Long-term outcome of radiological-guided insertion of implanted central venous access port devices (CVAPD) for the delivery of chemotherapy in cancer patients: institutional experience and review of the literature. Br J Cancer 91(6):1045–1049PubMedGoogle Scholar
  10. 10.
    Brooks AJ, Alfredson M, Pettigrew B et al (2005) Ultrasound-guided insertion of subclavian venous access ports. Ann R Coll Surg Engl 87(1):25–27CrossRefPubMedGoogle Scholar
  11. 11.
    Charvát J, Linke Z, Horáèková M et al (2006) Implantation of central venous ports with catheter insertion via the right internal jugular vein in oncology patients—single center experience. Support Care Cancer 14(11):1162–1165CrossRefPubMedGoogle Scholar
  12. 12.
    Cil BE, Canyigit M, Peynircioglu B et al (2006) Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol 12(2):93–98PubMedGoogle Scholar
  13. 13.
    Dede D, Akmangit I, Yildirim ZN et al (2008) Ultrasonography and fluoroscopy-guided insertion of chest ports. Eur J Surg Oncol 34(12):1340–1343PubMedGoogle Scholar
  14. 14.
    Biffi R, Orsi F, Pozzi S et al (2009) 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(5):935–940CrossRefPubMedGoogle Scholar
  15. 15.
    Inaba Y, Yamaura H, Sato Y (2007) Central venous access port-related complications in outpatient chemotherapy for colorectal cancer. Jpn J Clin Oncol 37(12):951–954CrossRefPubMedGoogle Scholar
  16. 16.
    Marcy PY (2008) Central venous access: techniques and indications in oncology. Eur Radiol 18(10):2333–2344CrossRefPubMedGoogle Scholar
  17. 17.
    Mansfield PF, Hohn DC, Fornage BD et al (1994) Complications and failures of subclavian-vein catheterization. N Engl J Med 331(26):1735–1738CrossRefPubMedGoogle Scholar
  18. 18.
    Randolph AG, Cook DJ, Gonzales CA et al (1996) Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature. Crit Care Med 24(12):2053–2058CrossRefPubMedGoogle Scholar
  19. 19.
    Hind D, Calvert N, McWilliams R et al (2003) Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ 327(7411):361–367CrossRefPubMedGoogle Scholar
  20. 20.
    Pirotte T, Veyckemans F (2007) Ultrasound-guided subclavian vein cannulation in infants and children: a novel approach. Br J Anaesth 98(4):509–514CrossRefPubMedGoogle Scholar
  21. 21.
    Silberzweig JE, Sacks D, Khorsandi AS et al (2003) Society of Interventional Radiology Technology Assessment Committee. Reporting standards for central venous access. J Vasc Interv Radiol 14(92):S443–S452PubMedGoogle Scholar
  22. 22.
    Merrer J, De Jonghe B, Golliot F et al (2001) Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 286(6):700–707CrossRefPubMedGoogle Scholar
  23. 23.
    Parienti JJ, Thirion M, Mégarbane B et al (2008) Femoral vs jugular venous catheterization and risk of nosocomial events in adults requiring acute renal replacement therapy: a randomized controlled trial. JAMA 299(20):2413–2422CrossRefPubMedGoogle Scholar
  24. 24.
    Feller-Kopman D (2007) Ultrasound-guided internal jugular access: a proposed standardized approach and implications for training and practice. Chest 132(1):302–309CrossRefPubMedGoogle Scholar
  25. 25.
    Orsi F, Grasso RF, Arnaldi P et al (2000) Ultrasound guided versus direct vein puncture in central venous port placement. J Vasc Access 1(2):73–77PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2010

Authors and Affiliations

  • Noriaki Sakamoto
    • 1
    Email author
  • Yasuaki Arai
    • 1
  • Yoshito Takeuchi
    • 1
  • Masahide Takahashi
    • 1
  • Masakatsu Tsurusaki
    • 1
  • Kazuro Sugimura
    • 2
  1. 1.Division of Diagnostic RadiologyNational Cancer Center HospitalTokyoJapan
  2. 2.Department of RadiologyKobe University HospitalKobe CityJapan

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