J Surg Ultrasound.  2021 Nov;8(2):48-54. 10.46268/jsu.2021.8.2.48.

Ultrasound-Guided Totally Implantable Venous Access: Comparison between Arm and Chest Ports in Solid Organ Cancer Patients

• Lim DH
• Yang JD
• Chung BH
• Yu HC
• Lee MR
• Hwang HP

• KMID: 2525884
• DOI: http://doi.org/10.46268/jsu.2021.8.2.48

Abstract

Purpose
The purpose of this study was to evaluate the safety, technical feasibility, and complications of ultrasound-guided placement of totally implantable venous access ports (TIVAPs) in the arm compared to the chest for patients with cancer in a single center.
Methods
We retrospectively identified 371 patients who underwent TIVAP implantation in the upper arm or chest between July 2018 and June 2019. Implantation via the upper arm (arm port) or the jugular vein (chest port) was performed under sonographic and fluoroscopic guidance after administering local anesthesia. Medical records were reviewed to determine technical success, complications, and the causes of port removal were analyzed.
Results
In total, 371 devices were implanted, 252 in the upper arm (n = 252) and 119 in the upper chest wall (n = 119). The technical success rate was 100%. There were fewer complications observed in the arm port group compared to the chest port group (13 vs 23 patients; 5.2% vs 19.3%), which was statistically significant (P = 0.002). The chest port group developed more complications per 1000 catheter days and had a higher total complication rate than the arm port group (P < 0.001). Local infection with abscess and wound dehiscence were the most common cause of port removal. Multivariate analysis showed that the implantable port in the arm involved a less complicated procedure (P = 0.002).
Conclusion
Implantation of TIVAPs in the upper arm is a safe and feasible procedure with a low rate of complications. TIVAPs in the upper arm may be a good alternative to TIVAPs in the chest.

Keyword

Neoplasms; Drug therapy; Vascular access devices; Arm

Figure

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  Fig. 1 Patients who underwent arm port and chest port. (A) A 63-year-old male patient with right colorectal cancer underwent arm port procedure (white arrow) on the right upper arm for adjuvant chemotherapy after right hemicolectomy. (B) A 68-year-old male patient underwent conventional port procedure (black arrow) on the right upper chest wall for adjuvant chemotherapy after Miles operation and for ultra-lower rectal cancer.

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  Fig. 2 Complication-free catheter survival.

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