Ultrasound-Guided Arm Ports: Indications, Techniques, and Management

Abstract

PurposeVarious venous access devices are available, including peripheral venous lines, peripherally inserted central catheters lines, and subcutaneous port catheters. The latter provides medium-to long-term venous access and includes medical devices that can be inserted either on the chest (chest ports) or in the arm (arm ports). We report the techniques, dedicated indications, and main complications of arm port insertion using the ultrasonography (US) guidance method. MethodsTips and tricks of percutaneous real-time US-guided vein access technique in the arm are reviewed, and a brief literature review is reported. ResultsTechnical feasibility is almost 99%. US guidance allows depiction of anatomic variants, reduces the number of failed attempts, and increases the technical access rate compared with venography-guided access. Comparison of arm ports to chest ports reveals a higher global complication rate. We also report typical (mechanical) complications and dedicated indications, including contraindications to chest port insertion and selected patients for whom chest ports are not possible (eg, those with breast, head, and neck cancer; obesity; cosmesis; and requiring upright position). ConclusionsArm port insertion under US guidance is safe and effective, and has dedicated indications.