Acute and Critical Care

Original Article

Thoracic Surgery
Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access: Pil Young Jung, Hoon Ryu, Jae Hung Jung, Eunbi Lee, Joong Hwan Oh, Chun Sung Byun, Il Hwan Park; Korean J Crit Care Med. 2015;30(1):13-17. Published online February 28, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.1.13; Correction in: Acute Crit Care 2015;30(4):365

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Background
Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach (Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax (n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8, 4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complication free probability is significantly higher in group 1 (p = 0.040). Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.

Citations

Citations to this article as recorded by

Internal jugular vein versus subclavian vein as the percutaneous insertion site for totally implantable venous access devices: a meta-analysis of comparative studies
Shaoyong Wu, Jingxiu Huang, Zongming Jiang, Zhimei Huang, Handong Ouyang, Li Deng, Wenqian Lin, Jin Guo, Weian Zeng
BMC Cancer.2016;[Epub] CrossRef

Case Report

Right Internal Jugular Venous Thrombosis Occurred after Long-term Placement of Hemodialysis Catheter Inserted Via Right Subclavian Vein: A Case Report: Mi Young Park, Il Woo Shin, Ju Tae Sohn, Heon Keun Lee, Young Kyun Chung; Korean J Crit Care Med. 2003;18(2):80-83.

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Abstract PDF: Central venous catheter-related venous thrombosis is one of the most important complications occurred after central venous catheterization. Forty six year old man had end-stage renal failure due to diabetes mellitus. Temporary hemodialysis catheter was inserted via right subclavian vein. Thirty days after hemodialysis catheter insertion, the patient presented with right neck swelling and difficulty to aspirate blood from hemodialysis catheter. Venography showed right internal jugular vein thrombosis. We report a case in which a patient developed right internal jugular vein thrombosis after long-term placement of temporary hemodialysis catheter.

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