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Updated: Jun 26, 2026
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Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein
Published on: January 13, 2026
Port-A-Cath implantation using percutaneous puncture without guidance
Yee-Huang Ku1, Pi-Hui Kuo, Yueh-Feng Tsai
1Department of Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
Annals of Surgical Oncology
|December 23, 2008
Summary
Port-A-Cath (PAC) implantation via subclavian vein puncture without intraoperative guidance is safe and effective. This method achieved a 98.6% correct catheter tip placement, demonstrating its reliability for chemotherapy patients.
Area of Science:
- Medical Devices
- Surgical Procedures
- Oncology
Background:
- Port-A-Cath (PAC) implantation is a common procedure often guided by fluoroscopy, ultrasound, or ECG.
- Un-guided PAC implantation offers benefits by reducing radiation exposure, time, cost, and complexity.
Purpose of the Study:
- To evaluate the success rate of PAC implantation without intraoperative guidance.
- To analyze operation-related and postoperative complications associated with un-guided PAC placement.
Main Methods:
- Retrospective review of 1,070 PAC implantations in 1,025 chemotherapy patients between July 2004 and June 2007.
- All PACs were placed via percutaneous subclavian vein puncture with pre-calculated catheter lengths.
- Postoperative chest radiography confirmed catheter tip position.
Main Results:
- Successful catheter tip placement at the cavoatrial junction in 98.6% of implants.
- Surgery-related complications occurred in 1.4% of cases (malposition, pneumothorax, hematoma, kinking).
- Postoperative complications leading to removal included occlusion (2.2%), pocket infection (2.1%), rupture (1.0%), and thrombosis (0.8%).
Conclusions:
- Percutaneous subclavian vein puncture without intraoperative guidance is a safe and accurate method for Port-A-Cath implantation.
- This technique minimizes procedural risks and resources while maintaining high success rates.
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