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. 2018 Jan-Feb;32(1):179-184.
doi: 10.21873/invivo.11222.

Totally Implantable Central Venous Port Catheters: Radiation Exposure as a Function of Puncture Site and Operator Experience

Martin Jonczyk  1   2 , Bernhard Gebauer  3 , Roman Rotzinger  3 , Dirk Schnapauff  3 , Bernd Hamm  3 , Federico Collettini  3   2
Affiliations

Totally Implantable Central Venous Port Catheters: Radiation Exposure as a Function of Puncture Site and Operator Experience

Martin Jonczyk et al. In Vivo. 2018 Jan-Feb.

Abstract

Background: Totally implantable central venous port systems provide a safe and effective, long-term means of access for administration of hyperosmolar, local irritant medication, such as chemotherapy, antibiotics and parenteral nutrition.

Aim: To evaluate the combination of access site and level of experience on fluoroscopy times (FT) and dose area products (DAP) during implantation of port catheters in a large patient population.

Materials and methods: A total of 1,870 patients (992 women, 878 men; age: 61±13.14 years) were reviewed investigating two groups of junior (≤50 implantations) and senior (>50) radiologists.

Results: Senior radiologists required less FT/DAP (0.24 s/57.3 μGy m2 versus 0.43 s/68.2 μGy m2, respectively; p<0.001). Right jugular vein access required the least FT/DAP (0.25 s/56.15 μGy m2) and right-sided implantation lower FT/DAP (right: 0.26 s/56.4 μGy m2, left: 0.40 s/85.10 μGy m2, p<0.001).

Conclusion: Due to DAP/FT reductions, the right jugular vein seems to be the most favorable implantation side for port systems. For further dose reduction, residents should be well-trained.

Keywords: Totally implantable central venous port systems; dose area product; fluoroscopy time; radiation exposure; training.

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Figures

Figure 1
Figure 1. Fluoroscopy time (FT) (A) and dose area product (DAP) (B) according to radiologist experience. Senior >50 implantations; Junior ≤50 implantations.
Figure 2
Figure 2. Fluoroscopy time (FT) (A) and dose area product (DAP) (B) according to puncture site. VJIL: Left internal jugular vein, VJIR: right internal jugular vein, VSCL: left subclavian vein, VSCR: right subclavian vein.
Figure 3
Figure 3. Fluoroscopy time (FT) (A) and dose area product (DAP) (B) according to access side.
See this image and copyright information in PMC

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