scholarly journals 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

2013 ◽  
Vol 04 (01) ◽  
pp. 161-164 ◽  
Author(s):  
Shinichiro Koketsu ◽  
Shinichi Sameshima ◽  
Yawara Kubota ◽  
Kosuke Hirano ◽  
Asami Suzuki ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Subclavian Vein ◽  
Jugular Vein ◽  
Venous Access ◽  
Access Device ◽  
Venous Access Device

Late fracture of Groshong ports: A report of the three cases

2019 ◽  
Vol 20 (5) ◽  
pp. 563-566 ◽  
Author(s):  
Fumito Saijo ◽  
Mitsuhisa Mutoh ◽  
Joho Tokumine ◽  
Odaka Yoshinobu ◽  
Hikaru Hama ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Access ◽  
Access Device ◽  
Device Implantation ◽  
Catheter Fracture ◽  
Venous Access Device ◽  
Enhanced Computed Tomography ◽  
Venous Access Devices

Background: Totally implantable venous access devices are valuable tools for total parenteral nutrition, chemotherapy, and long-term intravenous therapy. However, late catheter fracture is a well-known complication of totally implantable venous access device, particularly in Groshong silicone catheter. Recently, a specific type of totally implantable venous access device made with Groshong silicone has been introduced to facilitate power injection of contrast medium for enhanced computed tomography. Cases description: We reported three cases of catheter fracture in power-injectable Groshong silicone totally implantable venous access device. From May 2012 to August 2014, 66 patients underwent power-injectable Groshong silicone totally implantable venous access device implantation at our institution, with a median follow-up of 20.1 (range 0.2–58.1) months. The catheters in all patients were inserted into the internal jugular vein under ultrasound guidance and were connected to the port implanted in the upper chest through the subcutaneous tunnel. Chemotherapy was administered using these routes. Fractures of all three cases specifically showed a torn catheter section: smooth surface on one side, and a rough edge on the other side of the catheter, suggesting that long-term repeated stretch force may be related with the mechanism of fracture. Conclusion: Totally implantable venous access devices with Groshong silicone catheters, if inserted via the internal jugular vein, have a potential risk for late catheter fracture.

scholarly journals An unusual complication after placement of an inferior vena cava filter via right internal jugular vein access

2018 ◽  
Vol 20 (1) ◽  
pp. 102-104 ◽  
Author(s):  
Hala Nas ◽  
Dedrick Bowe ◽  
Ayman O Soubani
Keyword(s):  
Inferior Vena Cava ◽  
Internal Jugular Vein ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Jugular Vein ◽  
Vena Cava ◽  
Venous Access ◽  
Vena Cava Filter ◽  
Access Device ◽  
Venous Access Device

Introduction: Totally implantable venous access devices are used extensively worldwide in cancer patients for administration of venotoxic agents, blood sampling, and nutrition. Their tip is usually positioned at the junction of superior vena cava and right atrium. Inferior vena cava filters are usually used for deep venous thrombosis in cases where anticoagulation is contraindicated; they can be inserted either via internal jugular or femoral access depending on patient conditions and preference. Case description: We are describing here a case of totally implantable venous access device fracture following a right internal jugular approach for inferior vena cava filter placement as the patient had inferior vena cava thrombus below the renal veins, extending into the right common iliac vein prohibiting femoral approach. Conclusion: Iatrogenic fracture of totally implantable venous access device is a potential complication of accessing the internal jugular vein for other procedures such as insertion of inferior vena cava filter.

scholarly journals Forty years after the first totally implantable venous access device (TIVAD) implant: the pure surgical cut-down technique only avoids immediate complications that can be fatal

2021 ◽  
Author(s):  
Adriana Toro ◽  
Elena Schembari ◽  
Emanuele Gaspare Fontana ◽  
Salomone Di Saverio ◽  
Isidoro Di Carlo
Keyword(s):  
Surgical Technique ◽  
Jugular Vein ◽  
Surgical Techniques ◽  
Venous Access ◽  
Percutaneous Technique ◽  
Percutaneous Approach ◽  
Access Device ◽  
Long Time ◽  
Venous Access Device ◽  
Implanted Devices

Abstract Aim Even though TIVADs have been implanted for a long time, immediate complications are still occurring. The aim of this work was to review different techniques of placing TIVAD implants to evaluate the aetiology of immediate complications. Methods A systematic literature review was performed using the PubMed, Cochrane and Google Scholar databases in accordance with the PRISMA guidelines. The patient numbers, number of implanted devices, specialists involved, implant techniques, implant sites and immediate complication onsets were studied. Results Of the 1256 manuscripts reviewed, 36 were eligible for inclusion in the study, for a total of 17,388 patients with equivalent TIVAD implantation. A total of 2745 patients (15.8%) were treated with a surgical technique and 14,643 patients (84.2%) were treated with a percutaneous technique. Of the 2745 devices (15.8%) implanted by a surgical technique, 1721 devices (62.7%) were placed in the cephalic vein (CFV). Of the 14,643 implants (84.2%) placed with a percutaneous technique, 5784 devices (39.5%) were placed in the internal jugular vein (IJV), and 5321 devices (36.3%) were placed in the subclavian vein (SCV). The number of immediate complications in patients undergoing surgical techniques was 32 (1.2%) HMMs. In patients treated with a percutaneous technique, the number of total complications were 333 (2.8%): 71 PNX (0.5%), 2 HMT (0.01%), 175 accidental artery punctures AAP (1.2%) and 85 HMM (0.6%). No mortality was reported with either technique. Conclusion The percutaneous approach is currently the most commonly used technique to implant a TIVAD, but despite specialist’s best efforts, immediate complications are still occurring. Surgical cut-down, 40 years after the first implant, is still the only technique that can avoid all of the immediate complications that can be fatal.

Subcutaneous Port Malfunction: A Retrospective Comparison Between Internal Jugular and Subclavian Vein Access

2015 ◽  
Vol 20 (4) ◽  
pp. 229-234
Author(s):  
Mahmoud Samman ◽  
Tomas Mujo ◽  
John J. Harris ◽  
Douglas M. Coldwell ◽  
Melissa Hite-Potts ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Subclavian Vein ◽  
Preventive Measures ◽  
Jugular Vein ◽  
Venous Access ◽  
Port Catheter ◽  
Port Placement ◽  
Access Port ◽  
Vein Access ◽  
Retrospective Comparison

Abstract Purpose: To evaluate malfunction rates of subcutaneous chest ports placed via the internal jugular and subclavian veins. Analysis and preventive measures to reduce the risk of complication between the 2 sites of venous access will be discussed. Methodology: Retrospective review of 114 patients with malfunctioning subcutaneous port-a-catheters was performed. Of those 114 patients, 77 had venous access via a subclavian approach, whereas the remaining 37 had internal jugular vein access. Port insertion placement was evaluated and analysis of the malfunction rate was performed. Results: There were 36 patients with 38 subcutaneous port malfunctions from internal jugular vein access. Thirty-four of 38 complications (89%) were not related to insertion and 4 out of 38 (11%) were related to vascular access approach. Seventy-seven patients with malfunctioning subcutaneous ports placed via the subclavian vein had a total of 127 complications. Twenty-eight of 127 complications (22%) were not related to insertion and 99 out of 127 (78%) of the complications were directly related to venous access approach. Conclusions: Subcutaneous port placement complications can be avoided by measuring the length of the port catheter under fluoroscopic guidance and positioning the tip within 2 cm of the cavoatrial junction. Also, the jugular vein should be the first site for access unless patient circumstances do not permit this approach.

scholarly journals Pneumothorax and Subclavian Vein Thrombosis in Patients With Venous Access Device Implantation

2017 ◽  
Vol 102 (7-8) ◽  
pp. 382-386
Author(s):  
Valentina Bestetti ◽  
Roman Zeller ◽  
Anna S. Wenning ◽  
Kim T. Mouton ◽  
Wolfgang G. Mouton
Keyword(s):  
Subclavian Vein ◽  
Venous Access ◽  
Secondary Outcome ◽  
Chest Drain ◽  
Complication Rates ◽  
Access Device ◽  
Vein Thrombosis ◽  
Subclavian Vein Thrombosis ◽  
Venous Access Device ◽  
Length Of Hospitalization

The primary aim is to assess the length of hospitalization due to iatrogenic pneumothorax as a main complication of totally implantable venous access device (TIVAD) implantation. Secondary aim is to analyze the thrombogenic effects of different catheter diameters on the subclavian vein. Pneumothorax is a rare and may be underestimated, underdocumented, but serious complication in TIVAD of implantation using the subclavian vein puncture method. A total of 1155 consecutive patients with TIVAD implantation were assessed retrospectively over a 14-year time period. As primary outcome the length of hospitalization due to iatrogenic pneumothorax and as secondary outcome subclavian vein thrombosis (SVT) in relation to different TIVAD catheter sizes were analyzed. Pneumothoraces occurred 6 times (0.52%) and only when the subclavian vein was punctured. The median hospitalization for these patients was 8 days (5 of the 6 patients needed a chest drain). No pneumothoraces occurred when a peripheral vein was used for access (980 patients). SVTs were detected in 13 patients (1.1%) without any correlation to the diameter of the catheter. There was no significant correlation detected between the different tumor types and the complication rates. Iatrogenic pneumothorax may lead to hospitalization of 1 week or more. The costs then increase with additional chests x-rays, chest drain insertions, and hospitalization days. When making the choice for surgical venous cutdown or subclavian vein puncture to implant TIVAD, the consequences of iatrogenic pneumothorax should be considered as pneumothorax is a rare but serious complication of TIVAD implantation inherent to subclavian vein puncture.

Rare cause of extravasation from implantable venous access device

2021 ◽  
Vol 14 (2) ◽  
pp. e239103
Author(s):  
Ponmani Agasthiya Manimaran ◽  
Prakash Agarwal ◽  
Madhu Ramasundaram ◽  
Jegadeesh Sundaram
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Jugular Vein ◽  
Venous Access ◽  
Access Device ◽  
X Ray ◽  
Correct Placement ◽  
Intravenous Antibiotics ◽  
The Right ◽  
Venous Access Device ◽  
Venous Access Devices

Implantable venous access devices are routinely used, but they are not without complications. A 4-year-old male child with B cell acute lymphoblastic leukaemia was planned for chemotherapy. Chemo port was accessed through the right internal jugular vein. Check X-ray was done, which showed the correct placement of the catheter. Two months after chemo port insertion when the patient underwent chemotherapy, he developed a fever and he was started on intravenous antibiotics. On the next two admissions, the patient had a fever with chamber site oedema for which culture was done, which revealed Pseudomonas and Candida, which responded to antibiotic and antifungal therapies. In the successive admission, the patient had immediate local oedema on injecting chemotherapy. Exploration was done, which revealed chamber base perforation. It is an infrequent complication and has been reported in only three studies.

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