Abstract:

Objective

To discuss the technical skill and clinical safety of ultrasound-guided implantation of totally implantable venous access port (TIVAP) via axillary vein.

Methods

We retrospectively analyzed the data of 40 breast cancer patients receiving chemotherapy via TIVAP (research group) in Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University from September to December 2016. Fifteen patients were implanted with TIVAP via left axillary vein, and the other 25 were implanted with TIVAP via right axillary vein. Another 50 patients who received TIVAP via internal jugular vein served as control group. The successful rate, proportion of the patients with ≤2 punctures,operation time, intraoperative and postoperative complications were compared between 2 groups. t test was used to compare the operation time, and Fisher exact probability method was used to compare the rate.

Results

The implantation of TIVAP via axillary vein or internal jugular vein were performed successfully in all cases,with the successful rate of 100% (40/40, 50/50). The operative time in research group was significantly longer than that in control group [(26±4) min vs (22±3) min, t=-5.410, P<0.001]. However, the proportion of the patients with ≤2 punctures, incidence of pneumothorax and incidence of arterial injury showed no significant difference between 2 groups [research group vs control group: 97.5% (39/40) vs 96.0% (48/50), P=1.000; 0(0/40) vs 2.0% (1/50), P=1.000; 0(0/40) vs 4.0% (2/50), P=0.501]. There were no significant differences in thrombosis rate and infection rate between 2 groups [research group vs control group:2.5% (1/40) vs 0(0/50), P=0.444; 2.5% (1/40) vs 2.0% (1/50), P=1.000].

Conclusion

TIVAP implantation via axillary vein approach is a safe and effective technique with relatively low complication rate.

Key words: Breast neoplasms, Punctures, Catheters, indwelling, Catheterization, central venous, Axillary vein, Ultrasonography, Totally implantable venous access ports