JCT  Vol.4 No.1 , February 2013
Safety and Feasibility of the Venous Access via Internal Jugular Vein Puncture Approach for Totally Implantable Venous Access Device Placements Compared with Subclavian Vein Puncture
ABSTRACT

Background: The aim of this study was to evaluate the safety and feasibility of venous access via the internal jugular vein (IJV) for totally implantable venous access device (TIVAD) placements. In Japan, TIVADs are generally placed in position by the percutaneous subclavian vein puncture approach (SVPA). However, this approach causes infrequent intraoperative or postoperative complications. Using the internal jugular vein puncture approach (IJVPA), TIVADs could be placed more easily and safely. Materials and Methods: Fifty-six patients who received TIVADs for chemotherapy of colorectal carcinomas were enrolled in this study. The choice of approach (IJVPA or SVPA) was adopted at the discretion of each doctor in charge of the patient. The operation time, success rate and complications of the two approaches were compared and evaluated. Results: TIVAD placement was successful in all patients. Thirty patients received the device via IJV puncture, but 1 patient required conversion to SVPA. Twenty-six patients underwent SVPA for device placement, but 3 of these patients required conversion to IJVPA. Mean operation time was 34.3 min in IJVPA and 35.2 min in SVPA. The success rate was 96.6% in IJVPA and 88.5% in SVPA. No severe perioperative complications were observed. However, long-term complications were observed in five cases, 3 by IJVPA and 2 by SVPA, but no significant difference in the rate of complications was observed between these two approaches. A catheter-related thrombosis was found by CT scan in 3 patients, two of whom underwent IJVPA (6.7%) and one case underwent SVPA (3.8%). Two patients received simultaneous administration of bevacizumab. Catheter infections occurred in 1 patient who underwent IJVPA (3.3%) and 1 patient who underwent SVPA (3.8%). Conclusions: The IJVPA is a safe and feasible method for TIVAD placement.


Cite this paper
S. Koketsu, S. Sameshima, Y. Kubota, K. Hirano, A. Suzuki, N. Makino, Y. Sugamata, H. Yoshiba, T. Kakihara, M. Nozaki and M. Ooya, "Safety and Feasibility of the Venous Access via Internal Jugular Vein Puncture Approach for Totally Implantable Venous Access Device Placements Compared with Subclavian Vein Puncture," Journal of Cancer Therapy, Vol. 4 No. 1, 2013, pp. 161-164. doi: 10.4236/jct.2013.41023.
References
[1]   Pharmaceuticals and Medical Devices Agency in Japan, 2009. http://www.info.pmda. go.jp/kyoten_kiki/port.html#umekomi

[2]   R. Biffi, F. de Braud, F. Orsi, et al., “Totally Implantable Central Venous Access Ports for Long-Term Chemotherapy. A Prospective Study Analyzing Complications and Costs of 333 Devices with a Minimum Follow-Up of 180 Days,” Annals of Oncology, Vol. 9, No. 7, 1998, pp. 767-773. doi:10.1023/A:1008392423469

[3]   E. H. Kincaid, P. W. Davis, M. C. Chang, J. M. Fenstermaker and T. C. Pennell, “‘Blind’ Placement of Long-Term Central Venous Access Devices: Report of 589 Consecutive Procedures,” The American Journal of Surgery, Vol. 65, 1999, pp. 520-524.

[4]   R. L. Poorter, F. N. Lauw, W. A. Bemelman, P. J. Bakker, C. W. Taat and C. H. Veenhof, “Complications of an Implantable Venous Access Device (Port-A-Cath) during Intermittent Continuous Infusion of Chemotherapy,” European Journal of Cancer, Vol. 32A, No. 13, 1996, pp. 2262-2266. doi:10.1016/S0959-8049(96)00274-2

[5]   C. E. Nightingale, A. Norman, D. Cunningham, J. Young, A. Webb and J. Filshie, “A Prospective Analysis of 949 Long-Term Central Venous Access Catheters for Ambulatory Chemotherapy in Patients with Gastrointestinal Malignancy,” European Journal of Cancer, Vol. 33, No. 3, 1997, pp. 398-403. doi:10.1016/S0959-8049(97)89012-0

[6]   I. Di Carlo, F. Barbagallo, A. Toro, M. Sofia, R. Lombardo and S. Cordio, “External Jugular Vein Cutdown Approach, as a Useful Alternative, Supports the Choice of the Cephalic Vein for Totally Implantable Access Device Placement,” Annals of Surgical Oncology, Vol. 12, No. 7, 2005, pp. 1-4.

[7]   D. A. Andris, E. A. Krzywda, W. Schulte, R. Ausman and E. J. Quebbeman, “Pinch-Off Syndrome: A Rare Etiology for Central Venous Catheter Occlusion,” Journal of Parenteral and Enteral Nutrition, Vol. 18, No. 6, 1994, pp. 531-533. doi:10.1177/0148607194018006531

[8]   C. Plumhans, A. H. Mahnken, C. Ocklenburg, S. Keil, F. F. Behrendt, R. W. Günther and F. Schoth, “Jugular versus Subclavian Totally Implantable Access Ports: Catheter Position, Complications and Intrainterventional Pain Perception,” European Journal of Radiology, Vol. 79, No. 3, 2011, pp. 338-342. doi:10.1016/j.ejrad.2009.12.010

[9]   R. C. Ribeiro, S. C. Abib, A. S. Aguiar and S. T. Schettini, “Long-Term Complications in Totally Implantable Venous Access Devices: Randomized Study Comparing Subclavian and Internal Jugular Vein Puncture,” Pediatric Blood & Cancer, Vol. 58, No. 2, 2012, pp. 274-277. doi:10.1002/pbc.23220

[10]   C. Araújo, J. P. Silva, P. Antunes, J. M. Fernandes, C. Dias, H. Pereira, T. Dias and J. L. Fougo, “A Comparative Study between Two Central Veins for the Introduction of Totally Implantable Venous Access Devices in 1201 Cancer Patients,” European Journal of Surgical Oncology, Vol. 34, No. 2, 2008, pp. 222-226. doi:10.1016/j.ejso.2007.04.003

[11]   J. H. Lee, Y. B. Kim, M. K. Lee, J. I. Kim, J. Y. Lee, S. Y. Lee, E. J. Lee and Y. S. Lee, “Catastrophic Hemothorax on the Contralateral Side of the Insertion of an Implantable Subclavian Venous Access Device and the Ipsilateral Side of the Removal of the Infected Port—A Case Report,” Korean Journal of Anesthesiology, Vol. 59, No. 3, 2010, pp. 214-219. doi:10.4097/kjae.2010.59.3.214

[12]   D. H. Hinke, D. A. Zandt-Stastny, L. R. Goodman, E. J. Quebbeman, E. A. Krzywda and D. A. Andris, “Pinch-Off Syndrome: A Complication of Implantable Subclavian Venous Access Devices,” Radiology, Vol. 177, No. 2, 1990, pp. 353-356.

[13]   R. C. Ribeiro, A. C. Monteiro, Q. C. Menezes, S. T. Schettini and S. M. Vianna, “Totally Implantable Catheter Embolism: Two Related Cases,” Sao Paulo Medical Journal, Vol. 126, No. 6, 2008, pp. 347-349. doi:10.1590/S1516-31802008000600011

[14]   A. E. Krutchen, H. Bjarnason, D. J. Stackhouse, G. K. Nazarian, J. E. Magney and D. W. Hunter, “The Mechanisms of Positional Dysfunction of Subclavian Venous Catheters,” Radiology, Vol. 200, No. 1, 1996, pp. 159-163.

[15]   D. R. Aitken and J. P. Minton, “The ‘Pinch-Off Sign’: A Warning of Impending Problems with Permanent Subclavian Catheters,” The American Journal of Surgery, Vol. 148, No. 5, 1984, pp. 633-636. doi:10.1016/0002-9610(84)90340-4

[16]   M. Roelke, S. S. O’Nunain, S. Osswald, H. Garan, J. W. Harthorne and J. N. Ruskin, “Subclavian Crush Syndrome Complicating Transvenous Cardioverter Defibrillator Systems,” Pace, Vol. 18, No. 5, 1995, pp. 973-979. doi:10.1111/j.1540-8159.1995.tb04737.x

[17]   J. F. Timsit, J. C. Farkas, J. M. Boyer, J. B. Martin, B. Misset, B. Renaud and J. Carlet, “Central Vein Catheter-Related Thrombosis in Intensive Care Patients: Incidence, Risks Factors, and Relationship with Catheter-Related Sepsis,” Chest, Vol. 114, No. 1, 1998, pp. 207-213. doi:10.1378/chest.114.1.207

[18]   S. Macdonald, A. J. Watt, D. McNally, R. D. Edwards and J. G. Moss, “Comparison of Technical Success and Outcome of Tunneled Catheters Inserted via the Jugular and Subclavian Approaches,” Journal of Vascular and Interventional Radiology, Vol. 11, No. 2, 2000, pp. 225-231. doi:10.1016/S1051-0443(07)61470-5

[19]   A. Peris, G. Zagli, M. Bonizzoli, G. Cianchi, M. Ciapetti, R. Spina, V. Anichini, F. Lapi and S. Batacchi, “Implantation of 3951 Long-Term Central Venous Catheters: Performances, Risk Analysis, and Patient Comfort after Ultrasound-Guidance Introduction,” Anesthesia & Analgesia, Vol. 111, No. 5, 2010, pp. 1194-1201. doi:10.1213/ANE.0b013e3181f333c1

[20]   M. Yoshino, F. Kawahara, Y. Tanaka, M. Kaise, H. Nagai and Y. Takii, “A Study of Complications Associated with Central Venous Access Port Placement in Colorectal Cancer Patients Receiving Bevacizumab Chemotherapy,” Journal of Japanese Society of Hospital Pharmacists, Vol. 48, 2012, pp. 307-311.

 
 
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