Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan;46(1):43-48.
doi: 10.1007/s00270-022-03306-9. Epub 2022 Dec 12.

Alternate Cervical Venous Access Sites for Implantable Port Catheters: Experience at a Single Quaternary Care Institution

Frank K Liou  1 , Patrick Y Kim  2 , S Paran Yap  2 , Abdullah Khan  2 , Sandra Taylor  3 , Rex Pillai  2 , Eric King  2 , Amol Shah  2 , R Torrance Andrews  2 , Catherine T Vu  2 , Roger E Goldman  2
Affiliations

Alternate Cervical Venous Access Sites for Implantable Port Catheters: Experience at a Single Quaternary Care Institution

Frank K Liou et al. Cardiovasc Intervent Radiol. 2023 Jan.

Abstract

Introduction: Clinical outcomes of implantable port catheters (IPCs) placed via alternative veins such as the external jugular and cervical collaterals have not been well established. This investigation evaluates the short- and long-term outcomes of IPCs inserted via alternate cervical veins (ACV) compared to traditionally inserted IPCs via the internal jugular vein (IJV).

Materials and methods: A total of 24 patients who received an IPC between 2010 and 2020 via an ACV-defined as the external jugular vein, superficial cervical vein, or unnamed collateral veins-were identified. Based on power analysis, a matched control group of 72 patients who received IPCs via the IJV was identified. Non-inferiority analysis for port complications was performed between the two groups based on the selected non-inferiority margin of 20%. Secondary end points included complication-free survival and comparison of complications by the time at which they occurred.

Results: ACV access was non-inferior to traditional access for overall complications. Alternate access resulted in fewer complications than traditional access with an estimated reduction of - 7.0% [95% CI - 23.6%, 39.7%]. There was no significant difference in peri-procedural and post-procedural complications between the two groups. Complication-free survival was also equivalent between the two groups.

Conclusion: IPC placement via ACVs was non-inferior to IPCs placed via traditional access through the IJV. When abnormal pathology obviates the use of IJV access, other cervical veins may be considered prior to seeking alternate locations such as femoral, translumbar, inferior vena cava, and hepatic veins.

Keywords: Central vein occlusion; Central venous access; Port complications.

PubMed Disclaimer

Conflict of interest statement

This study was funded by the National Center for Advancing Translational Sciences, National Institutes of Health. The authors declare that they have no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of retrospective review study, formal consent for participation and publication is not required.

Figures

Fig. 1
Fig. 1
Kaplan–Meier estimates for freedom from major complication
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Inoue Y, Kusunoki M. Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review. Surg Today. 2014;44:1406–1414. doi: 10.1007/s00595-013-0672-8. - DOI - PMC - PubMed
    1. Barton JC, Barton JC, Bertoli LF. Implanted ports in adults with primary immunodeficiency. J Vasc Access. 2018;19:375–377. doi: 10.1177/1129729818757966. - DOI - PubMed
    1. Gordon AC, Saliken JC, Johns D, Owen R, Gray RR. US-guided puncture of the internal jugular vein: complications and anatomic considerations. J Vasc Interv Radiol. 1998;9:333–338. doi: 10.1016/S1051-0443(98)70277-5. - DOI - PubMed
    1. Saugel B, Scheeren TWL, Teboul JL. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care. 2017;21(1):225. doi: 10.1186/s13054-017-1814-y. - DOI - PMC - PubMed
    1. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database Syst Rev. 2015;1(1):CD006962. - PMC - PubMed