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Related Concept Videos

Cardiac Catheterization III: Left Heart Catheterization01:24

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Port first vs. Tip first: does difference in portacath insertion techniques reduce complication rates.

Hannah Tang1, Sherab Bhutia1

  • 1General Surgery, Cairns Hospital, Cairns, Queensland, Australia.

ANZ Journal of Surgery
|February 11, 2023
PubMed
Summary

The port first technique for intravenous jugular port placement offers superior accuracy and reduced thrombosis compared to the tip first method. This finding highlights a significant improvement in central venous access device insertion outcomes.

Keywords:
central venous cathetersgeneral surgeryport devicevascular surgery

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Area of Science:

  • Vascular Surgery
  • Medical Device Technology
  • Patient Safety

Background:

  • Accurate central venous access device (CVAD) placement is crucial for preventing complications like infection, thrombosis, and migration.
  • Two common insertion techniques for intravenous jugular (IVJ) ports are fixation of port first (PF) and tip first (TF).

Purpose of the Study:

  • To audit and compare complication rates and catheter tip placement accuracy between the PF and TF IVJ port insertion techniques.
  • To evaluate the impact of insertion technique on the incidence of infection, thrombosis, and device migration.

Main Methods:

  • A retrospective audit of 227 patients undergoing IVJ port insertions at Cairns Hospital from 2019 to 2021.
  • Data were extracted from the Australia Vascular Audit database, focusing on accurate catheter tip placement, line infections, and thrombosis rates.
  • Comparison of outcomes between the port first (PF) and tip first (TF) insertion groups.

Main Results:

  • The PF group demonstrated a higher rate of accurate catheter tip placement (81.6%) compared to the TF group (69.8%).
  • Line-related thrombosis rates were significantly lower in the PF group (1%) versus the TF group (6.2%).
  • Infection rates were comparable between the two techniques (PF: 5.1%, TF: 6.2%).

Conclusions:

  • The port first (PF) technique for IVJ port device placement is associated with statistically significant improvements in accuracy and reduced thrombosis rates.
  • Further multicenter studies with larger populations are recommended to validate these findings and compare practitioner results.