Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

Abstract

Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

Keywords: intravenous port; standard algorithm; totally implantable vascular access device.

Figure 1

Standard algorithm of intravenous port implantation.

Figure 2

Variation trends of complication rate, incidence, and operation. (A) Variation trends of procedure- and catheter-related complication rates. (B) Variation trend of procedure- and catheter-related complication incidences. (C) Relative risk ratio between Year 2005 and Year 2018 cohorts. (D) Variation trend of operation time.