Early Results of Totally Implantable Central Venous Access Port Insertion Through a Supraclavicular Approach

Abstract

Cancer patients usually require repeated venous punctures for chemotherapy or other reasons. Therefore, totally implantable venous access port (TIVAP) systems have been helpful for patients with difficult vascular access. The purpose of this study was to evaluate the safety and feasibility of the totally implantable venous access port (TIVAP) implanted using a supraclavicular approach. After identification of the anatomical landmarks (clavicular head of the sternocleidomastoid muscle) for a supraclavicular approach, the patient was anesthetized with 1% lidocaine. After puncturing the central vein with an 18-G needle, the Seldinger catheterization procedure was performed. Between March 2017 and February 2018, 89 totally implantable venous access ports (TIVAPs) were inserted in 89 consecutive patients (32 men and 57 women) with a mean age of 57.5 years (range, 19–89 years) through a supraclavicular approach. Successful totally implantable venous access port (TIVAP) implantation was achieved in 96.6% (86 of 89) of patients. In 2 patients, port catheter placement failed despite successful vascular puncture because a wire could not be passed after cannulation of the blood vessel. The other case of failed placement was due to development of pneumothorax during vascular puncture. Venous port-related complications such as bleeding, infection, thrombosis, malfunction, or catheter fracture did not occur within 2 postoperative weeks. Totally implantable venous access port (TIVAP) implantation through the supraclavicular approach can be performed safely and feasibly for oncologic patients with difficult central or peripheral venous access.