Axillary versus Jugular Vein for Totally Implanted Port-A-Cath, Randomized, Controlled Trial

Area of Science:

• Vascular Surgery
• Oncology
• Medical Devices

Background:

• Port-a-cath (PORT) devices are crucial for systemic intravenous treatments in cancer patients.
• Choosing the optimal venous access point is critical for PORT safety and efficacy.

Purpose of the Study:

• To compare the safety and efficacy of internal jugular vein versus axillary vein access for PORT implantation.
• To evaluate complication rates and thrombosis incidence between the two access methods.

Main Methods:

• Randomized controlled trial involving 213 cancer patients.
• Ultrasound and radioscopy-guided PORT placement via axillary or jugular vein.
• Assessment of total complication rates using intention-to-treat and per-protocol analyses.

Main Results:

• Overall complication rates were low and comparable between axillary and jugular vein access groups.
• A higher incidence of thrombosis was observed in the axillary vein access group, necessitating PORT removal in 4 patients.

Conclusions:

• Internal jugular vein access is a practical alternative to axillary vein access for PORT implantation.
• While axillary access offers benefits like a single incision, jugular access may be preferable due to its anatomical advantages and lower thrombosis risk, especially in high-risk patients.