Deltoid Branch of Thoracoacromial Vein

Abstract

An entry vessel is crucial for intravenous port implantation. A safe alternative entry vessel that can be easily explored is crucial for patients without feasible cephalic vein or for those who need port reimplantation because of disease relapse. In this study, we tried to analyze the safety and feasibility of catheter implantation via the deltoid branch of the thoracoacromial vein.From March 2012 to November 2013, 802 consecutive oncology patients who had received intravenous port implantation via the superior vena cava were enrolled in this study. The functional results and complications of different entry vessels were compared.The majority of patients (93.6%) could be identified as thoracoacromial vessel. The deltoid branch of the thoracoacromial vein is located on the medial aspect of the deltopectoral groove beneath the pectoralis major muscle (85.8%) and in the deep part of the deltopectoral groove (14.2%). Due to the various calibers employed and tortuous routes followed, we utilized 3 different methods for catheter implantation, including vessel cutdown (47.4%), wire assisted (17.9%), and modified puncture method (34.6%). The functional results and complication rate were similar to other entry vessels.The deltoid branch of the thoracoacromial vein is located in the neighborhood of the cephalic vein. The functional results of intravenous port implantation via the deltoid branch of the thoracoacromial vein are similar to other entry vessels. It is a safe alternative entry vessel for intravenous port implantation.

The axillary vein and its tributaries are not in the mirror image of the axillary artery and its branches

“…However, knowledge of their course may useful in planning new kinds of venous approach. In a feasibility study investigating the implantation of an intravenous port through the deltoid tributary of the thoracoacromial vein, immediate catheter implantation via the tributary was possible in only 47.4% of the patients, as the vessel was found to be too tortuous for the procedure in the remaining patients [24]. One possible explanation for the difficulties might be that the tortuous vessels of the deltoid venous tributaries they encountered during the procedures were not heading to the axillary vein, but were instead tributaries to the cephalic vein, like many of those found in this study.…”

“…In addition, identifying a safe alternative entry vessel is crucial for the treatment of patients when access via the usual insertion sites is impossible [24]. Increased knowledge and information about superficial veins in the upper arm would help determine alternate means of venous access in cases where planned venous access is inadequate [14].…”

The Treatment Results of a Standard Algorithm for Choosing the Best Entry Vessel for Intravenous Port Implantation

“…We utilized deltoid branch of thoracoacromial vein as an alternative substitute of subclavian vein because it is located at neighborhood area of deltopectoral groove. 5 However, varying vessel calibers and potentially tortuous routes may be encountered, which would require metallic wire to be used to establish an implantation route prior to the catheter implantation. Patients with adequate vessel caliber can have the catheter implanted over the wire.…”

“… 4 Due to its proximity to the deltopectoral groove, the deltoid branch of the thoracoacromial vein may be used as an alternative. 5 With the help of both of these vessels, only 5% of patients may lack an adequate native vessel in this area that could cause difficulties in intravenous port implantation. 5 The puncture method may be required for entry vessel access in this clinical scenario.…”

“… 5 With the help of both of these vessels, only 5% of patients may lack an adequate native vessel in this area that could cause difficulties in intravenous port implantation. 5 The puncture method may be required for entry vessel access in this clinical scenario.…”