Radiology Implanted Forearm Ports: A Review of the Literature

2017 ◽  
Vol 22 (1) ◽  
pp. 22-30
Author(s):  
Brent Burbridge ◽  
Ian Y. M. Chan ◽  
Rhonda Bryce ◽  
Chel-Hee Lee ◽  
Hyun J. Lim
Keyword(s):  
Interventional Radiology ◽  
Venous Access ◽  
Radiology Department ◽  
Success Rates ◽  
Review Of The Literature ◽  
Port Implantation ◽  
Port Systems ◽  
A Prospective Study ◽  
Review Criteria

Abstract Background: Insertion of totally implanted venous access devices; that is, port systems, in the forearm is an option for long-term venous access. To better understand the radiology literature reported for this anatomic location, we performed a search for, and an analysis of, previous publications related to forearm implantation of these devices by interventional radiology department personnel. Materials and Methods: A review of the literature was performed for articles describing radiology implantation of forearm ports. Articles published between 1990 and 2015 were reviewed. Results: Eleven articles were found that met the review criteria. None were randomized studies and only 1 was a prospective study. All of the other studies were retrospective reviews of a variety of different port devices. An analysis of these articles was performed. Conclusions: Forearm port implantation had high technical success rates (range, 98%–100%; mean, 99.7%). A wide variety of complications were encountered, none of which exceeded the Society of Interventional Radiology threshold levels for complications associated with port insertion. A subset of the studies were upper arm venipunctures with the port catheter and housing subsequently implanted in the forearm distal to the antecubital fossa.

Radiology-Implanted Arm Ports: A Review of the Literature

2015 ◽  
Vol 20 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Brent Burbridge ◽  
Grant Stoneham ◽  
Hyun J. Lim ◽  
Chel-Hee Lee
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
English Language ◽  
Human Beings ◽  
Review Of The Literature ◽  
Technical Success ◽  
Upper Arm ◽  
Technical Success Rate ◽  
Port Implantation ◽  
Port Systems

Abstract Introduction: Placement of totally implanted venous access devices, or port systems, in the upper arm is becoming a common practice in interventional radiology. To gain a better understanding of the literature in this area, we performed a search for and analysis of previous publications related to upper arm implantation of these devices by members of interventional radiology departments. Methods: A review of the literature pertaining to upper arm port systems implanted in human beings by members of interventional radiology departments was performed, assessing publications between the years 1992 and 2014. Only English-language publications were assessed. Results: Eighteen publications met selection criteria during the time frame reviewed. None of the studies used a prospective, randomized design; rather, all studies consisted of case–cohort descriptions of outcomes for a single device or for multiple devices. Analysis of the available literature for interventional radiology-inserted arm ports was performed. The technical success rate ranged between 93.7% and 100%, with an average of 98.9%. Conclusions: The high technical success rate of arm port implantation and the elimination of the potential for pneumothorax, hemothorax, catheter pinch-off syndrome, and subclavian and carotid artery injury are strengths of the arm implantation strategy. There was wide variation in the rates of complications detected, in addition to inconsistent study design and study implementation strategies.

scholarly journals ADVANTAGES OF PORT-SYSTEMS COMPARED WITH VARIOUS METHODS OF LONG-TERM VENOUS ACCESS IN ONCOLOGY

2018 ◽  
Vol 6 (4) ◽  
pp. 346-358
Author(s):  
A. P. Kolesnik ◽  
A.V. Kadzhoian ◽  
S.M. Machuskhiy ◽  
K.O. Bolshakova ◽  
D.Ye. Cherniavskiy
Keyword(s):  
Venous Access ◽  
Port Systems

scholarly journals Puncture of the Axillary Vein for the Implant for Electronic Cardiac Devices

2018 ◽  
pp. 17-24
Author(s):  
Vagner Rossato Pegoraro ◽  
Eduardo Rodrigues Bento Costa ◽  
Luiz Fernando Fagundes Gouvea Filho ◽  
Beatriz Tose Costa Paiva
Keyword(s):  
Subclavian Vein ◽  
Venous Access ◽  
Long Term Results ◽  
Axillary Vein ◽  
Success Rates ◽  
Cardiac Devices ◽  
Increased Risk ◽  
Different Types ◽  
Short And Long Term

Introduction: The obtaining of venous access for implantation of implantable electronic cardiac devices (IECDs) has been traditionally made by intrathoracic subclavian vein puncture (SVP) or cephalic vein phlebotomy (CVP). Evidence indicates, however, the increased risk of short-term and long-term complications with SVP due to the fact that it is intrathoracic access and the risk of compression of the electrodes by the costoclavicular ligament, leading to different types of defects. CVP, in turn, has been associated with a failure rate that reaches 45%. Axillary vein puncture (AVP) has been described in the literature and is presented here as an alternative to the two techniques mentioned. Methods: A PubMed survey was conducted on articles that mention the AVP, SVP and CVP techniques and compare them to the immediate, short and long term results and success rates for obtaining venous access. Emphasis was placed on comparisons between the various AVP techniques. Conclusion: The AVP technique for obtaining venous access presents some variations among the different authors. It has CVP-like safety, success rates comparable to those of the subclavian vein, and better medium and long term results for electrode function.

Power-injectable totally implantable venous access devices – analysis of success and complication rates of ultrasound-guided implantation and a patient satisfaction survey

VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 524-530
Author(s):  
Julia Kunz-Virk ◽  
Karsten Krüger
Keyword(s):  
Patient Satisfaction ◽  
Venous Access ◽  
Late Complications ◽  
Subjective Rating ◽  
Complication Rates ◽  
Safe Procedure ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Port Implantation ◽  
Venous Access Devices

Summary. Background: To retrospectively evaluate the success rates, peri-interventional, early and late complications and patient satisfaction associated with power-injectable totally implantable venous access devices (TIVAPs). Patients and methods: Between April 2011 and March 2016, a total of 1,203 TIVAPs were implanted in 1,169 patients. Ultrasound-guided, fluoroscopically controlled implantation was performed through the subclavian or internal jugular vein. The systematic analysis focused on the rate of successful port implantations, the frequency of peri-interventional, early and late complications and on how the experience of the implanting radiologist impacts these parameters. Additionally, a standardized questionnaire was administered to the 102 study patients in a telephone interview to survey their subjective rating of the port implantation. Results: 99.5 % of TIVAPs were implanted successfully. In 4 out of 6 patients, the implantation was repeated successfully at a later time. Complication rates were 1.4 % (0.0512/1.000 catheter days) for peri-interventional, 2.9 % (0.081 per 1,000 catheter days) for early and 8.3 % (0.2288 per 1,000 catheter days) for late complications. The radiologist’s experience level and vein selection did not have a significant impact. Most peri-interventional complications (82.4 %) were of minor severity. The early (61.5 %) and late (65.6 %) complications were more frequently of major severity. Interventions to manage complications comprised port explanation in 46.9 %, conservative therapy in 17.4 % and interventional therapy in 12.2 %. At 1 and 3 months after port placement, the majority were satisfied or very satisfied with the interventional port implantation. Conclusions: Ultrasound-guided, fluoroscopically controlled implantation of TIVAPs is a safe procedure with low complication rates, high success rates and high patient satisfaction.

Radiology

2019 ◽  
pp. 509-524
Author(s):  
Laura Bowes
Keyword(s):  
Interventional Radiology ◽  
General Anaesthesia ◽  
Interventional Procedures ◽  
Venous Access ◽  
Diagnostic Radiology ◽  
Radiology Department ◽  
Breath Hold ◽  
Mri Scan ◽  
Large Numbers

This chapter covers both diagnostic and interventional radiology. Unlike adults, many children require general anaesthesia or sedation to be able to cooperate with diagnostic radiology, e.g. a breath hold during CT chest, or keeping still for a long MRI scan. Commonly, general anaesthesia is delivered in the radiology department. This can mean the anaesthetist is working remotely from colleagues and therefore must be experienced and aware of the potential hazards in this environment (e.g. radiation). Increasingly, interventional procedures are being performed in children (e.g. venous access), with large numbers of personnel and equipment often involved; therefore, organisation and planning are imperative. This chapter helps highlight the issues involved.

Surgical and interventional radiological management of adult epistaxis: systematic review

2017 ◽  
Vol 131 (12) ◽  
pp. 1108-1130 ◽  
Author(s):  
C Swords ◽  
A Patel ◽  
M E Smith ◽  
R J Williams ◽  
I Kuhn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Effect ◽  
Interventional Radiology ◽  
Search Strategy ◽  
Database Search ◽  
Economic Effects ◽  
Success Rates ◽  
Review Of The Literature ◽  
Artery Ligation ◽  
Sphenopalatine Artery

AbstractBackground:There is variation regarding the use of surgery and interventional radiological techniques in the management of epistaxis. This review evaluates the effectiveness of surgical artery ligation compared to direct treatments (nasal packing, cautery), and that of embolisation compared to direct treatments and surgery.Method:A systematic review of the literature was performed using a standardised published methodology and custom database search strategy.Results:Thirty-seven studies were identified relating to surgery, and 34 articles relating to interventional radiology. For patients with refractory epistaxis, endoscopic sphenopalatine artery ligation had the most favourable adverse effect profile and success rate compared to other forms of surgical artery ligation. Endoscopic sphenopalatine artery ligation and embolisation had similar success rates (73–100 per cent and 75–92 per cent, respectively), although embolisation was associated with more serious adverse effects (risk of stroke, 1.1–1.5 per cent). No articles directly compared the two techniques.Conclusion:Trials comparing endoscopic sphenopalatine artery ligation to embolisation are required to better evaluate the clinical and economic effects of intervention in epistaxis.

scholarly journals Safety of immediate use of totally implantable venous access ports in adult patients with cancer: a retrospective single-center study

2021 ◽  
Vol 17 (2) ◽  
pp. 104-110
Author(s):  
Jisu Lee ◽  
Sung Mo Hur ◽  
Zisun Kim ◽  
Cheol Wan Lim
Keyword(s):  
Proportional Hazards Model ◽  
Multivariable Analysis ◽  
Venous Access ◽  
Cox Proportional Hazards ◽  
Interquartile Range ◽  
Cox Proportional Hazards Model ◽  
Morbidity Rate ◽  
Chemotherapy Administration ◽  
Port Implantation

Purpose: Totally implantable venous access ports (TIVAPs) can be used long-term for safe administration of intravenous drugs. TIVAP complications include catheter-related infections, venous thrombosis, extravasation, TIVAP migration, and pain. The relationship between the timing of the first chemotherapy administration after port implantation and complications is controversial. This study aimed to investigate the safety of immediate use of TIVAPs and the associated risk factors for complications.Methods: Between January 2016 and December 2018, 305 patients (median age, 53 years; 256 women) who underwent TIVAP placement at our institution were included. Chemotherapy was administered within 2 days of implantation. A retrospective analysis of patients’ clinical data was performed to investigate catheter days and complications of TIVAPs.Results: Overall, 305 patients were evaluated over 57,324 catheter days (median, 168 catheter days; interquartile range, 105). The median interval between placement and first use of TIVAPs was 0.98 days. The overall morbidity rate was 2.95%. Nine complications occurred in nine patients, including TIVAP-related infection (4), pain (2), port occlusion (1), thrombosis (1), and scar disunion (1), of which five required port removal (1.64%). The median number of catheter days before complications occurred was 61 (range, 10–457 days; interquartile range, 51). No complications occurred within 7 days of implantation. Body mass index was an independent risk factor for TIVAP-related complications in the Cox proportional hazards model (multivariable analysis: hazard ratio, 1.221; 95% confidence interval, 1.054–1.414; P = 0.008).Conclusion: This study suggests the safe long-term use of TIVAPs following their immediate chemotherapy administration within 2 days of implantation.

scholarly journals O32 COVID-19 mortality after vascular procedures during the initial UK surge: moving forward with elective vascular work

2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
P Liu ◽  
S M Cheema ◽  
I Adeoye ◽  
N S Theivacumar ◽  
S T Hussain ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Minimally Invasive ◽  
Elective Surgery ◽  
Radiology Department ◽  
Safety Measures ◽  
The United Kingdom ◽  
Reduce Risk ◽  
Interventional Radiology Department

Abstract Introduction Following the initial COVID-19 surge in the United Kingdom, there was a national incentive for elective vascular surgery to be restricted to clean sites in order to reduce perioperative cross infection and subsequent mortality. We assessed the risk of dying from perioperatively acquired COVID-19 during the peak of the London outbreak. Materials and Methods 43 consecutive patients who had vascular (n = 48) procedures in March and April 2020 at a regional hub serving five London hospitals were analysed. The patients were screened for COVID-19 in the 30-day postoperative period and the main outcome measure was mortality from COVID-19. A comparison was then made with patients who underwent minimally invasive procedures from our integrated interventional radiology department. Median follow-up was 41 days (IQR 8–58 days). Result Three patients (7%) in the vascular group (median age 61 years, all diabetic, two male) died from COVID-19, all of whom tested positive postoperatively. Two others became positive but recovered. In comparison, two patients (2%) in the interventional radiology group died from COVID-19, however one was positive prior to their procedure. Conclusion Only urgent vascular cases should be performed during a COVID-19 surge, with elective work delayed or continued at clean sites. However, with growing waiting lists for elective surgery currently, further restrictions may not be a viable long-term solution. Resumption of care at hot sites should be considered, if resources allow for it and if safety measures can be implemented. The advantages of minimally invasive surgery may inherently reduce risk as well. Take-home Message Only urgent vascular cases should be performed during a peak outbreak of COVID-19, however we cannot continue to postpone elective procedures indefinitely or restrict all cases to solely clean sites. The resumption of care at hot sites encompasses a fine balance of risks versus benefits.

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