For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
42
views
33
references
 Top references
cited by
2
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      329
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Perioperative and Postoperative Complications of Supraclavicular, Ultrasound-Guided, Totally Implantable Venous Access Port via the Brachiocephalic Vein in Adult Patients: A Retrospective Multicentre Study

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose

          The totally implantable venous access port (TIVAP) provides patients with safe, effective and long-term convenient venous access for the administration of medications such as chemotherapy drugs. The implantation and long-term use of TIVAP are related to thrombosis, infection and other complications. In this study, the medical records of multicentre patients were collected, and the perioperative and postoperative complications were retrospectively analysed to objectively evaluate the safety of the implantation of supraclavicular, ultrasound-guided TIVAP via the brachiocephalic vein (BCV).

          Patients and Methods

          We retrospectively analysed the clinical data of 433 adult patients who had undergone ultrasound-guided TIVAP implantation via the BCV at four hospitals in China from March 2018 to May 2019. The success rates of the first puncture, operation time, and perioperative and postoperative complications were analysed.

          Results

          All the TIVAPs were implanted successfully (100%). The average TIVAP carrying time was 318.15 ±44.22 days (range: 38–502 days) for a total of 197,694 catheter days. The success rate of the first puncture was 94.92% (411/433), and the average operation time was 29.66 ±7.45 min (range: 18–60 min). The perioperative complications included arterial puncture in 4 patients and pneumothorax in 1 patient. The incidence of postoperative complications was 5.08% (22/433), including poor incision healing (n = 2), catheter-related infection (n = 3), port infection (n = 6), thrombosis (n = 2) and fibrin sheath formation (n = 8). Another patient had infusion disturbance 2 days after the operation, and chest X-ray showed bending at the connection between the catheter and port. No other serious complications occurred, such as catheter rupture and drug leakage. The total incidence of complications was 6.24% (27/433).

          Conclusion

          This study showed excellent tolerance of supraclavicular, ultrasound-guided BCV puncture to implant TIVAP and a low incidence of complications. As a safe and effective method of TIVAP implantation, it can provide a new choice for clinicians.

          Most cited references33

          • Record: found
          • Abstract: found
          • Article: not found

          Complications of central venous catheters: internal jugular versus subclavian access--a systematic review.

          Martin Tramèr, Bernhard Walder, Sibylle Ruesch (2002)
          To test whether complications happen more often with the internal jugular or the subclavian central venous approach. Systematic search (MEDLINE, Cochrane Library, EMBASE, bibliographies) up to June 30, 2000, with no language restriction. Reports on prospective comparisons of internal jugular vs. subclavian catheter insertion, with dichotomous data on complications. No valid randomized trials were found. Seventeen prospective comparative trials with data on 2,085 jugular and 2,428 subclavian catheters were analyzed. Meta-analyses were performed with relative risk (RR) and 95% confidence interval (CI), using fixed and random effects models. In six trials (2,010 catheters), there were significantly more arterial punctures with jugular catheters compared with subclavian (3.0% vs. 0.5%, RR 4.70 [95% CI, 2.05-10.77]). In six trials (1,299 catheters), there were significantly less malpositions with the jugular access (5.3% vs. 9.3%, RR 0.66 [0.44-0.99]). In three trials (707 catheters), the incidence of bloodstream infection was 8.6% with the jugular access and 4.0% with the subclavian access (RR 2.24 [0.62-8.09]). In ten trials (3,420 catheters), the incidence of hemato- or pneumothorax was 1.3% vs. 1.5% (RR 0.76 [0.43--1.33]). In four trials (899), the incidence of vessel occlusion was 0% vs. 1.2% (RR 0.29 [0.07-1.33]). There are more arterial punctures but less catheter malpositions with the internal jugular compared with the subclavian access. There is no evidence of any difference in the incidence of hemato- or pneumothorax and vessel occlusion. Data on bloodstream infection are scarce. These data are from nonrandomized studies; selection bias cannot be ruled out. In terms of risk, the data most likely represent a best case scenario. For rational decision-making, randomized trials are needed.
          Article 0 comments Cited 135 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice

            Bernd Saugel, Thomas W L Scheeren, Jean-Louis Teboul (2017)
            The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the current evidence and existing guidelines for its use. In addition, we recommend a structured approach for US-guided central venous access for clinical practice. Static and real-time US can be used to visualize the anatomy and patency of the target vein in a short-axis and a long-axis view. US-guided needle advancement can be performed in an "out-of-plane" and an "in-plane" technique. There is clear evidence that US offers gains in safety and quality during CVC placement in the internal jugular vein. For the subclavian and femoral veins, US offers small gains in safety and quality. Based on the available evidence from clinical studies, several guidelines from medical societies strongly recommend the use of US for CVC placement in the internal jugular vein. Data from survey studies show that there is still a gap between the existing evidence and guidelines and the use of US in clinical practice. For clinical practice, we recommend a six-step systematic approach for US-guided central venous access that includes assessing the target vein (anatomy and vessel localization, vessel patency), using real-time US guidance for puncture of the vein, and confirming the correct needle, wire, and catheter position in the vein. To achieve the best skill level for CVC placement the knowledge from anatomic landmark techniques and the knowledge from US-guided CVC placement need to be combined and integrated.
            Article 0 comments Cited 110 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization.

              Patrick Brass, Martin Hellmich, Laurentius Kolodziej … (2015)
              Central venous catheters (CVCs) can help with diagnosis and treatment of the critically ill. The catheter may be placed in a large vein in the neck (internal jugular vein), upper chest (subclavian vein) or groin (femoral vein). Whilst this is beneficial overall, inserting the catheter risks arterial puncture and other complications and should be performed with as few attempts as possible. Traditionally, anatomical 'landmarks' on the body surface were used to find the correct place in which to insert catheters, but ultrasound imaging is now available. A Doppler mode is sometimes used to supplement plain 'two-dimensional' ultrasound.
              Article 0 comments Cited 108 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Ther Clin Risk Manag
                Journal ID (iso-abbrev): Ther Clin Risk Manag
                Journal ID (publisher-id): tcrm
                Journal ID (pmc): tcriskman
                Title: Therapeutics and Clinical Risk Management
                Publisher: Dove
                ISSN (Print): 1176-6336
                ISSN (Electronic): 1178-203X
                Publication date (Electronic): 04 February 2021
                Publication date Collection: 2021
                Volume: 17
                Pages: 137-144
                Affiliations
                [1 ]Department of Intervention, The Second Affiliated Hospital of Soochow University , Suzhou, 215004, Jiangsu, People’s Republic of China
                [2 ]Department of Intervention, Wuxi People’s Hospital Affiliated to Nanjing Medical University , Wuxi, 214023, Jiangsu Province, People’s Republic of China
                [3 ]Department of General Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine , Changshu, 215500, Jiangsu, People’s Republic of China
                [4 ]Department of Anesthesiology, Bazhong Central Hospital , Bazhong, Sichuan, 636000, People’s Republic of China
                [5 ]Department of Radiology, The First Affiliated Hospital of Soochow University , Suzhou, 215004, Jiangsu, People’s Republic of China
                Author notes
                Correspondence: Yong Jin Department of Intervention, The Second Affiliated Hospital of Soochow University , Suzhou, 215004, Jiangsu, People’s Republic of ChinaTel +86 13776097707 Email 578898234@qq.com
                Ling Wen Department of Radiology, The First Affiliated Hospital of Soochow University , Suzhou, 215004, Jiangsu, People’s Republic of China Email wenling@suda.edu.cn
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0003-4949-0699
                http://orcid.org/0000-0002-6639-145X
                Article
                Publisher ID: 292230
                DOI: 10.2147/TCRM.S292230
                PMC ID: 7869700
                PubMed ID: 33568912
                SO-VID: a5879ff8-b938-49e6-bad3-db5f32541d10
                Copyright © © 2021 Yu et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 21 November 2020
                Date accepted : 20 January 2021
                Page count
                Figures: 2, Tables: 2, References: 34, Pages: 8
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Medicine
                Keywords: complications,totally implantable venous access ports,ultrasound-guided,brachiocephalic vein
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: complications, totally implantable venous access ports, ultrasound-guided, brachiocephalic vein

                Comments

                Comment on this article

                scite_

                Similar content329

                See all similar

                Cited by2

                See all cited by

                Most referenced authors426

                See all reference authors