Image-Guided Chemoport Insertion by a Vascular Surgeon: A Technique for Minimizing Complications
1Division of Transplantation and Vascular Surgery, Department of Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Republic of Korea.
Introduction:
Totally implantable central venous port systems are essential for administering long-term chemotherapy in cancer patients, minimizing complications from repeated peripheral vein access. Despite advancements in technique and devices, procedural complications remain a concern. This study presents a safe, efficient method for chemoport implantation performed by a vascular surgeon using image-guided techniques.
Methods:
This retrospective analysis included 443 adult patients who underwent chemoport insertion form March 2022 and September 2023 at a single tertiary care center. All procedures were conducted by the same vascular surgeon using ultrasound-guided internal jugular vein (IJV) puncture and fluoroscopic guidance for catheter placement. The Celsite Safety Port Kit was used in all cases. Data on demographics, procedural details, and complications were collected from electronic medical records.
Results:
Of the 443 patients (mean age 54.0 y; 95.3% female), 90.3% had breast cancer. The right IJV was accessed in 56.7%, and the left IJV was accessed in 43.1%. The mean catheter indwelling duration was 318.6 d. Average catheter lengths were 21.2 cm (via right IJV) and 23.7 cm (via left IJV). No intraoperative or early complications occurred. Nine (2.0%) patients experienced late complications: four infections, two thrombotic events, one skin erosion, one device malfunction, and one chamber site infection. All complications were successfully managed with no procedure-related mortality.
Conclusions:
Standardized, image-guided chemoport insertion by a vascular surgeon results in a low complication rate. The catheter length measurements may serve as a useful reference, particularly in settings lacking fluoroscopic guidance.
