Perioperative and Postoperative Complications of Supraclavicular, Ultrasound-Guided, Totally Implantable Venous Access Port via the Brachiocephalic Vein in Adult Patients: A Retrospective Multicentre Study

Zepeng Yu,1,* Xingwei Sun,1,* Xuming Bai,1 Wei Ding,2 WeiDong Wang,2 Liang Xu,3 Wenming Qin,4 Ling Wen,5 Yong Jin1 1Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, People’s Republic of China; 2Department of Intervention, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, Jiangsu Province, People’s Republic of China; 3Department of General Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, 215500, Jiangsu, People’s Republic of China; 4Department of Anesthesiology, Bazhong Central Hospital, Bazhong, Sichuan, 636000, People’s Republic of China; 5Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yong JinDepartment of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, People’s Republic of ChinaTel +86 13776097707Email 578898234@qq.comLing WenDepartment of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, People’s Republic of ChinaEmail wenling@suda.edu.cnPurpose: The totally implantable venous access port (TIVAP) provides patients with safe, effective and long-term convenient venous access for the administration of medications such as chemotherapy drugs. The implantation and long-term use of TIVAP are related to thrombosis, infection and other complications. In this study, the medical records of multicentre patients were collected, and the perioperative and postoperative complications were retrospectively analysed to objectively evaluate the safety of the implantation of supraclavicular, ultrasound-guided TIVAP via the brachiocephalic vein (BCV).Patients and Methods: We retrospectively analysed the clinical data of 433 adult patients who had undergone ultrasound-guided TIVAP implantation via the BCV at four hospitals in China from March 2018 to May 2019. The success rates of the first puncture, operation time, and perioperative and postoperative complications were analysed.Results: All the TIVAPs were implanted successfully (100%). The average TIVAP carrying time was 318.15 ± 44.22 days (range: 38– 502 days) for a total of 197,694 catheter days. The success rate of the first puncture was 94.92% (411/433), and the average operation time was 29.66 ± 7.45 min (range: 18– 60 min). The perioperative complications included arterial puncture in 4 patients and pneumothorax in 1 patient. The incidence of postoperative complications was 5.08% (22/433), including poor incision healing (n = 2), catheter-related infection (n = 3), port infection (n = 6), thrombosis (n = 2) and fibrin sheath formation (n = 8). Another patient had infusion disturbance 2 days after the operation, and chest X-ray showed bending at the connection between the catheter and port. No other serious complications occurred, such as catheter rupture and drug leakage. The total incidence of complications was 6.24% (27/433).Conclusion: This study showed excellent tolerance of supraclavicular, ultrasound-guided BCV puncture to implant TIVAP and a low incidence of complications. As a safe and effective method of TIVAP implantation, it can provide a new choice for clinicians.Keywords: complications, totally implantable venous access ports, ultrasound-guided, brachiocephalic vein