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| The advantage of "visualization" in the whole process of venous port |
| WEI Wen-jiang, LI Li-heng, DU Yu-dan, ZHAO Zhi-xiang, XIAO Ke-xi, TANG Ying-hong, XIAO Cheng-jiang |
| Department of Intervention, Guangdong Second Provincial General Hospital, Guangzhou 510317, China |
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Abstract Objective: To evaluate the effectiveness and safety of ultrasound(US)-guided vein puncture and fluoroscopy localization for a totally implantable venous access port(TIVAP) implantation. Methods: We reviewed the medical records of 223 patients who underwent TIVAP at our hospital between March 2014 and October 2017. 104 with ultrasound-guided puncture and fluoroscopy localization(visual group) and 119 following anatomical landmarks(blind-puncture group). Puncture-related complications including short-term and long-term complications were analyzed. Results: Primary success rate was higher in visual group than blind-puncture group. Verified by fluoroscopy, all the end of catheters were successfully located at the junction of the superior vena cava and the right atrium(between the fifth thoracic vertebra (T5) and T7) in visual group, versus 86 cases in blind-puncture group. Several complications observed in blind-puncture group were arterial puncture(10 patients), pneumothorax(3 patients), thrombosis outside the catheter(14 patients), thrombosis inside the catheter(11 patients) and pinch-off syndrome(1 patients). None complications mentioned above were observed in visual group. In addition, intraductal infection was observed in 2 patients in visual group, comparing 12 patients in blind-puncture group. Infection of port body was not observed in visual group, versus 1 case with blind technique. Rupture of incision was found in 1 case in the visual group, versus 2 cases in blind-puncture group. Conclusions: US-guided vein puncture for TIVAP is easier for the operator and safer for the patient than blind technique by exposing anatomical structures. Verified by fluoroscopy, all the end of catheters are successfully located at the junction of the superior vena cava and the right atrium, reduces short-term and long-term complications.
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Received: 20 June 2018
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2019, Vol. 30 
