Comparison between ultrasound-guided TIVAD via the right innominate vein and the right internal jugular vein approach

Abstract

BackgroundTo compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to explore the advantages and disadvantages of the two approaches.MethodsSix hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed.ResultsAll patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P = 0.020). The incidence of perioperative complications and long-term complications in the right INV group were 1.18% (4/339) and 3.54% (12/339), respectively, while those in the right IJV group were 1.43% (4280) and 3.93% (11280). There was no significant difference in the incidence of perioperative or long-term complications between the two groups (P = 0.785, P = 0.799, respectively).ConclusionsUS-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.

Perioperative and Postoperative Complications of Ultrasound-Guided Totally Implantable Venous Access Ports via the Brachiocephalic Vein in Patients with Cancer: A Prospective Study

“…The exact mechanism of the low incidence of catheter malposition or rupture is not clear. In a retrospective study of 280 patients with TIVAP via IJV, the incidence of perioperative complications and long-term complications in the right IJV group were 1.43% (4/280) and 3.93% (11/280), respectively, including catheter malposition in 2 cases, and catheter fracture in 1 case 18 .…”

Review article: Feasibility of brachiocephalic vein central venous access for the resuscitation of shocked adult trauma patients: A literature review

“…34 In these two studies, involving a total of 338 patients, the incidence of arterial puncture was lower than in TIVAD insertion into the SCV. 33,34 Sun et al 35 also conducted a study comparing percutaneous US-guided TIVAD insertion into the right IJV (280 insertions) and RBCV (339 insertions). The first attempt success rate was higher in the BCV group (99%) than the IJV group (95%); however, there was no statistically significant difference in the incidence of perioperative or long-term complications.…”

“…This suggests that the BCV approach is as safe and reliable as other, more widely used sites of TIVAD insertion. 35…”

Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

“…Major issues related to intravenous port implantation include first attempt success rate [ 1 , 2 , 3 ] and peri-operative and late complications [ 4 , 5 , 6 , 7 ]. Several native vessels can be used as the entry vessel for chest port insertion, including the cephalic vein [ 2 , 3 ], deltoid branch of the thoracoacromial vein [ 8 ], the axillary vein [ 1 , 9 ], the internal jugular vein [ 3 ], the external jugular vein [ 2 ], the left brachiocephalic vein [ 10 , 11 ], and the subclavian vein [ 12 , 13 , 14 ]. However, different implantation methods are used for different target vessels and varying long-term results have been reported.…”