Port-A-Cath Placement without the Aid of Fluoroscopy or Localizing Devices

Abstract

In our study, only two catheters (1.9%) needed to be repositioned. This comes at an estimated savings of USD 40,000 for this series. Based on our experience, Port-A-Caths can be placed safely without fluoroscopy or localization devices with no added morbidity and significant cost savings to the patient.

Intravenous electrocardiography helps inexperienced operators to place totally implantable venous access device more accurately

“…In order to decrease radiation exposure, operation time, expense, and complexity, percutaneous TIVAD insertion either from subclavian vein or internal jugular vein without fluoroscope and localizing guidance was reported with comparable outcome. Catheter malposition and re‐implantation rates without guidance were around 1.9–2.3% 9, 11–12, slightly lower than our study. However, in our study, pre‐screen with IV‐ECG can reduce immediate revisions to none, even for inexperienced operators.…”

Ultrasound and Fluoroscopy-Guided Placement of Central Venous Ports via Internal Jugular Vein: Retrospective Analysis of 1254 Port Implantations at a Single Center

“…In the radiologic placement of a CVP, the procedure was performed under the guidance of US and fluoroscopy and using the Seldinger technique (6, 15). US-guidance enables the evaluation of the patency and the size of vessels, clear visualization of a vessel to guide puncture and, therefore, a high technical success rate of nearly 100% (4, 11, 13, 15, 22). Fluoroscopy-guidance enables the visualization of the location of a catheter tip, and the course of a catheter, as well as immediate evaluation of port function.…”

A simple method to accurately position Port‐A‐Cath without the aid of intraoperative fluoroscopy or other localizing devices

“…Every attempt to perform a repeat procedure required an extra 5 min (mean time, data not shown). However, the mean operative time was only 34 min, which was significantly less and offered a timesaving benefit compared with both previous reports [8][9][10][11] and the control group (group II) using imaging guidance.…”

“…In addition, using the C-arm fluoroscope would not be cost-effective; LaBella's [11] group reported that the cost of PAC insertion with the aid of the C-arm guide is USD174 per case, when surgery can be finished within 1 hr, and with the aid of fluoroscopy, the cost is USD396. Furthermore, the maintenance of the C-arm machine, including the staff and a special surgical X-ray protective room, is expensive even when no further pay would be offered to the patients when we used the C-arm as assistance for PAC insertion in Taiwan.…”