Chest Port Placement with Use of the Single-incision Insertion Technique

Hearns W. Charles, Tiago Miguel, Sandor Kovacs, Arash Gohari, Joseph Arampulikan, Jeffrey W. McCann

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: To evaluate the single-incision technique for the placement of subcutaneous chest ports. Advantages, technical success, and complications were assessed. Materials and Methods: From March 2007 through May 2008, 161 consecutive chest ports were placed with a modified single-incision technique and sonographic and fluoroscopic guidance via the right internal jugular vein (IJV; n = 130), right external jugular vein (n = 1), right subclavian vein (n = 1), or left IJV (n = 28). The primary indication was for long-term chemotherapy; all patients had malignancy. Results: All single-incision chest port insertions were technically successful. Ports were placed in patients 19 months to 93 years of age (mean, 56.3 y), with a mean follow-up of 203.6 device-days per patient and a total of 32,779 catheter access days. No procedure-related complications, pocket hematomas, venous thromboses, or pneumothoraces were observed. Minor delayed complications occurred in three patients. Premature catheter removal was required for two patients (1.2%; 0.006 per 100 catheter-days). One port was removed less than 30 days after implantation for infection of the pocket (0.61%; 0.003 per 100 catheter-days). Another catheter was removed because of patient dissatisfaction and unconfirmed concerns with arrhythmia (0.61%; 0.003 per 100 catheter-days). One minor superficial wound infection was successfully treated with oral antibiotics, with the port kept in place. Conclusions: Use of a single-incision technique for chest port implantation in adult and pediatric oncology patients is feasible. This may be the preferred method of subcutaneous port placement, as it has a very low complication rate and a high success rate. Prospective evaluation is needed to compare it versus the conventional two-incision technique.

Original languageEnglish (US)
Pages (from-to)1464-1469
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume20
Issue number11
DOIs
StatePublished - Nov 2009
Externally publishedYes

Fingerprint

Thorax
Catheters
Jugular Veins
Subclavian Vein
Pneumothorax
Wound Infection
Venous Thrombosis
Hematoma
Cardiac Arrhythmias
Pediatrics
Anti-Bacterial Agents
Drug Therapy
Equipment and Supplies
Infection
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Chest Port Placement with Use of the Single-incision Insertion Technique. / Charles, Hearns W.; Miguel, Tiago; Kovacs, Sandor; Gohari, Arash; Arampulikan, Joseph; McCann, Jeffrey W.

In: Journal of Vascular and Interventional Radiology, Vol. 20, No. 11, 11.2009, p. 1464-1469.

Research output: Contribution to journalArticle

Charles, Hearns W. ; Miguel, Tiago ; Kovacs, Sandor ; Gohari, Arash ; Arampulikan, Joseph ; McCann, Jeffrey W. / Chest Port Placement with Use of the Single-incision Insertion Technique. In: Journal of Vascular and Interventional Radiology. 2009 ; Vol. 20, No. 11. pp. 1464-1469.
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abstract = "Purpose: To evaluate the single-incision technique for the placement of subcutaneous chest ports. Advantages, technical success, and complications were assessed. Materials and Methods: From March 2007 through May 2008, 161 consecutive chest ports were placed with a modified single-incision technique and sonographic and fluoroscopic guidance via the right internal jugular vein (IJV; n = 130), right external jugular vein (n = 1), right subclavian vein (n = 1), or left IJV (n = 28). The primary indication was for long-term chemotherapy; all patients had malignancy. Results: All single-incision chest port insertions were technically successful. Ports were placed in patients 19 months to 93 years of age (mean, 56.3 y), with a mean follow-up of 203.6 device-days per patient and a total of 32,779 catheter access days. No procedure-related complications, pocket hematomas, venous thromboses, or pneumothoraces were observed. Minor delayed complications occurred in three patients. Premature catheter removal was required for two patients (1.2{\%}; 0.006 per 100 catheter-days). One port was removed less than 30 days after implantation for infection of the pocket (0.61{\%}; 0.003 per 100 catheter-days). Another catheter was removed because of patient dissatisfaction and unconfirmed concerns with arrhythmia (0.61{\%}; 0.003 per 100 catheter-days). One minor superficial wound infection was successfully treated with oral antibiotics, with the port kept in place. Conclusions: Use of a single-incision technique for chest port implantation in adult and pediatric oncology patients is feasible. This may be the preferred method of subcutaneous port placement, as it has a very low complication rate and a high success rate. Prospective evaluation is needed to compare it versus the conventional two-incision technique.",
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