The utilization of guidewires for adjusting the intraoperative catheter malposition during the venous access port implantation: A retrospective study

Abstract

This study presents an in-depth exploration of various adjustment methods for intraoperative catheter malposition by guidewires in the implantation of totally implantable venous access ports (TIVAP). It not only aims to summarize these methods but also endeavors to identify the most advantageous approach. The patient list was searched using the hospital information system from January 1, 2022, to October 31, 2023. All patients who had undergone chest port placement using the axillary vein (AxV) or subclavian vein (SCV) approach were reviewed, and further imaging was performed to confirm the guidewire applied to adjust the guidewire or catheter from the internal jugular vein into the superior vena cava (SVC) under fluoroscopy. Demographic data, diagnoses, technical outcomes, and perioperative complications were collected. About 32 patients with an average age of 62.8 years were included in the study. The operation time was 29.3 ± 13.3 minutes and SVC selecting time was 16.9 ± 11.5 seconds. The dose of X-ray exposure was only 7.2 ± 9.0 μGym2. Adjustments combined the guidewire with the puncture needle had the shortest SVC selection time and operation time with a minimal radiation dose. intraoperative catheter malposition can be timely and effectively adjusted using guidewires under fluoroscopy during any process of TIVAP implantation. Timely adjustment using a guidewire after inserting into the puncture needle is an optimal choice for a smooth and successful operation.