The Advantages and Safety of Ultrasound-Guided Infusion Port Implantation via Axillary Vein

The aim of this study was to assess the safety and clinical applications of ultrasound-guided infusion port implantation via axillary vein.

A retrospective analysis was conducted by reviewing the clinical data of 40 patients who underwent ultrasound-guided implantation of a totally implantable venous access port (TIVAP) by a single-center retrospective study (the Seventh People's Hospital of Chongqing) between September and December 2018. Among the 40 patients, 15 patients underwent implantation of a TIVAP via the left axillary and 25 patients underwent right axillary vein. Fifty patients who underwent puncture of the right internal jugular vein and indwelling of a TIVAP during the same period were recruited as controls. The success rate, percentage of patients who required ≤2 punctures, surgical time, and incidence of intraoperative and postoperative complications were compared between the 2 groups. A Fisher's exact test was used to compare ratios and a t-test was used to compare the surgical time between the 2 groups.

TIVAP was successfully implanted via the axillary or internal jugular vein under ultrasound guidance in all patients, and the success rate was 100% (40/40 and 50/50, respectively). The experimental group's surgery time is longer than that of the control group. However, the length of time is not statistically significant [26 ± 4 min vs. 22 ± 3 min, P = 0.000]. There were no significant differences in the percentage of patients requiring ≤2 punctures, the incidence of intraoperative pneumothoraces, and the incidence of mistaken punctures of arteries between the 2 groups [97.5% (39/40) vs. 96.0% (48/50), P = 1.000; 0 (0/40) vs. 2.0% (1/50), P = 1.000; and 0 (0/40) vs. 4.0% (2/50), P = 0.501]. Also, there were no appreciable variations in the frequency of long-term postoperative complications. (e.g., thrombosis and infection) between the 2 groups [2.5% (1/40) vs. 0 (0/50), P = 0.444; 2.5% (1/40) vs. 2.0% (1/50), P = 1.000].

Transaxillary vein ultrasound-guided implantation of a TIVAP is a low-risk, high-efficiency procedure with low rate of complication.