Totally implantable venous access ports: A prospective randomized study comparing subclavian and internal jugular vein punctures in children

Abstract

Background and objectives: Totally implantable venous access ports (TIVAPs) are essential in children who require long-term intermittent intravenous therapy.

Methods: Patients who needed to undergo TIVAP implantation were randomly assigned to the internal jugular vein group or the subclavian vein group. The medical histories, operative details and major complications from the time of port implantation to 48 h after port removal were collected. During the use of TIVAPs, satisfaction surveys were regularly conducted for the children and guardians and compared in the two groups.

Results: A total of 216 patients in the subclavian vein group and 199 patients in the internal jugular vein group were included. TIVAPs were successfully implanted in all children. The incidence of postoperative venous access occlusion in the subclavian vein group and internal jugular vein group was 1.5% and 5%, respectively, and the difference was statistically significant (P < 0.05). The average satisfaction score of the children and guardians in the subclavian vein group was 9.6 ± 0.3, and that in the internal jugular vein group was 8.3 ± 0.8. There was a significant difference between the 2 groups (P < 0.05).

Conclusions: Subclavian vein should be the first choice for TIVAP implantation in children.

The level of evidence rating: Treatment study level I.

Keywords: Central venipuncture; Internal jugular vein; Pinch-off syndrome; Subclavian vein; Totally implantable venous access ports.