Is routine chest X-ray necessary after ultrasound-guided TIVAP insertion through the internal jugular vein?

This study evaluated routine chest X-ray necessity following ultrasound-guided totally implantable venous access port (TIVAP) placement via internal jugular vein.

We retrospectively analysed 97 adults who underwent ultrasound-guided TIVAP placement at a tertiary cardiovascular surgery clinic in Eastern Turkey (December 2023-December 2024). Intraoperative port functionality (blood aspiration/fluid infusion) and postprocedural chest X-ray findings were assessed. Catheter positions were categorised as optimal, suboptimal, or malpositioned.

Among 97 patients (56.7% male; mean age 57.4 ± 15.0 years), pneumothorax occurred in one patient (1.0%), requiring intervention. Nineteen patients (19.6%) had suboptimal/malpositioned catheter tips but required no corrective action as port functionality remained intact. Radiographic findings prompted intervention in only one patient (1.0%).

Routine post-procedural chest X-ray identified catheter tip malpositioning in a subset of patients; however, these findings did not alter clinical management in the absence of port dysfunction. Selective imaging in patients with failed port functionality may safely reduce unnecessary radiation exposure and healthcare costs without compromising outcomes.