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A GAVeCeLT-IVAS bundle for the Safe Insertion of Midline Catheters: The SIMiC protocol.

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Updated: Jan 11, 2026

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A GAVeCeLT bundle for chest-port insertion: The SIC-Port protocol.

Fabrizio Brescia1, Maria Giuseppina Annetta2, Fulvio Pinelli3

  • 1Unit of Anesthesia and Intensive Care Medicine, Vascular Access Team, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy.

The Journal of Vascular Access
|November 13, 2025
PubMed
Summary

The SIC-Port bundle, a new approach to inserting totally implantable venous access devices (ports), uses evidence-based strategies to reduce complications. This safe insertion of chest-port technique is now standard in training courses.

Keywords:
Ultrasound guidancecentral venous accesscentrally inserted central catheterschest-portpatient safetystandardized assessment

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Area of Science:

  • Vascular Surgery
  • Medical Devices
  • Interventional Radiology

Background:

  • Totally implantable venous access devices (ports) are crucial for long-term patient access, particularly in oncology.
  • Traditional port insertion involves direct cannulation of supra/infra-clavicular veins, carrying potential complications.
  • Minimizing complications associated with port insertion is a key clinical objective.

Purpose of the Study:

  • To introduce and describe the SIC-Port (Safe Insertion of Chest-Port) bundle, an evidence-based insertion protocol.
  • To detail the eight steps of the SIC-Port bundle designed to minimize complications.
  • To highlight the adoption of the SIC-Port bundle in training courses by the Italian Group of Long-Term Venous Access Devices (GAVeCeLT).

Main Methods:

  • Systematic ultrasound evaluation of veins using the Rapid Central Venous Assessment (RaCeVA) protocol.
  • Adherence to strict hygiene, antisepsis, and maximal barrier precautions.
  • Ultrasound-guided cannulation, tip navigation, and pleural assessment, with preference for the axillary vein.
  • Intra-procedural tip location confirmation using ECG and/or echocardiography.
  • Standardized creation and closure of the subcutaneous pocket.

Main Results:

  • The SIC-Port bundle integrates multiple evidence-based strategies for safer port insertion.
  • The protocol emphasizes ultrasound guidance throughout the procedure for vein selection, cannulation, and tip placement.
  • It includes specific steps for pleural assessment and confirmation of optimal tip positioning.
  • The bundle aims to reduce immediate, early, and late complications associated with chest-port placement.

Conclusions:

  • The SIC-Port bundle represents a comprehensive, evidence-based approach to chest-port insertion.
  • Implementation of the SIC-Port bundle can potentially minimize procedural complications.
  • The protocol's adoption in training courses signifies its value in improving patient safety and procedural outcomes.