Abstract
Introduction: Totally implantable access ports (TIAPs) are commonly used in oncologic patients undergoing ongoing chemotherapy. The methods of choice for implantation are the subclavian vein puncture approach and the cephalic vein cutdown technique, followed by internal jugular vein access and external jugular vein access.
Materials and methods: We analyzed all patients who had a central venous access implanted by a single surgeon at the University Hospital in Pleven between October 2018 and January 2022, with the aim of determining the success rate and safety of the cephalic cutdown technique for placing totally implantable access ports.
Results: 135 totally implantable access ports were inserted in the study period. Median age of patients was 69.2 years (range, 35-86 years). There were 71 (52.59%) women and 64 (47.41%) men. In 7 patients, the tip of the catheter was reported to go at the distal part of the subclavian vein and axillary vein on the ipsilateral side after initial placement and was repositioned under real-time fluoroscopic guidance. Successful placement of a totally implantable access port using the cephalic cutdown technique was reported in 127 patients (94.07%). No postoperative pneumothorax, hemothorax, or vessel injury were reported. One case of surgical site infection was seen on postoperative day (POD) 7. Late postoperative complications occurred in 3 patients with catheter-related bacteremia all after POD 30 (81, 95, and 172 days after the procedure). One patient died.
Conclusions: Totally implantable access ports placed using the cephalic vein cutdown technique can be used safely and with high success rates in oncological patients.