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.

Background: Studies have reported factors affecting the efficacy of subcutaneous venous chest port catheters placed into jugular or subclavian veins using a radiological technique. There is ongoing debate for this efficacy in these series.

Objectives: This study aims to use mean volume of fluid, which is drained from a liver hydatid cyst with cystobiliary fistula developing after percutaneous treatment, for determining the type of treatment as surgery versus conservative. Patients and Methods:The cohort data was collected retrospectively from 10 out of 90 hydatid cysts in 10 out of 65 patients treated percutaneously with needle and catheterization methods. Groups were defined as surgical and conservative. The mean volumes until the 20 th day after detection of the biliary fistula were used. In addition, the mean volumes until the 20 th day of 42 catheterization patients without biliary fistula were used as controls for quantitative analysis.Results: All 10 cysts with cystobiliary fistulas were managed with small (8 F) catheters. All patients in the conservative group had < 211 mL/day mean drainage for the 20 days. For the patients that developed cystobiliary fistulas of liver hydatid disease, 30% required surgical treatment. After receiver operating characteristic (ROC) curve analysis, the cut-off value for success of hydatid cyst treatment was 206 mL/day of drained content. Conclusion:To reduce superfluous costs and time, cystobiliary fistula with < 206 mL/day mean drainage until the 20 th day may be efficiently treated with percutaneous drainage using small catheters.

Purpose: Catheter-related complications are observed in infusion of chemotherapy, and these were encountered with targeted therapies. Our principle is to study non-mechanical effects of type and initiation time of chemotherapy among the other factors on patency of totally implantable vascular access devices (TIVAD) inserted in patients with colorectal carcinoma. Methods: This is a one-center retrospective cohort study. We analyzed TIVAD related complications in 624 patients with colorectal carcinoma. The patients were categorized by chemotherapy type (non-target-directed chemotherapy agents (Group A), bevacizumab (Group B), and cetuximab (Group C)). Additionally, we divided the patients into groups by the time interval between TIVAD insertion and chemotherapy initiation. According to our study, a 3-day period was optimal. Therefore, we named the groups as within 3 days and beyond 3 days, and called this process 3 days cut-off. Age, gender, jugular-subclavian access, platelet count, INR, the types of chemotherapy, and the initiation time of chemotherapy were investigated by survival tests. We compared chemotherapy type groups both one-by-one and combined into one group. Results: The TIVADs were removed due to the complications in 11 patients of Group A, 6 patients of Group B, and 3 patients of Group C. Only chemotherapy type was significant ( p = 0.011) in Cox regression test. A clear difference ( p = 0.010) was detected between the catheter patency of Group A and combination of Groups B and C, because of skin necrosis and thrombosis. Within 3 days of their first chemotherapy day, an important difference between Group A and Group C ( p = 0.013) was observed in the TIVAD patency. The same observation was made between Group A and Group B ( p = 0.007). Beyond this period, no major difference was detected ( p = 0.341). Conclusion: A major effect on catheter patency was detected by using the target-directed chemotherapy agent within 3 days, which should be considered in target-directed chemotherapy.