• Aging Clin Exp Res · Feb 2017

    Efficacy and safety of ultrasound-guided placement of central venous port systems via the right internal jugular vein in elderly oncologic patients: our single-center experience and protocol.

    • Alfonso Canfora, Claudio Mauriello, Antonio Ferronetti, Gianpaolo Marte, Vittorio Di Maio, Guido Ciorra, Maria Grazia Esposito, Maria Elena Giuliano, Giovanni Fregola, Luigi Barra, Salvatore Cuzzovaglia, Vincenzo Bottino, and Pietro Maida.
    • Department of General Surgery, Evangelic Hospital Villa Betania, Via Argine 604, 80147, Naples, Italy. al.canfora@gmail.com.
    • Aging Clin Exp Res. 2017 Feb 1; 29 (Suppl 1): 127-130.

    BackgroundUltrasound-guidance has become the routine method for internal jugular vein (IJV) catheterization reducing dramatically failure and complication rates for central venous port (CVP) placement.AimsThe aim of this study was to determine the safety and efficacy of ultrasound-guided IJV CVP placement in elderly oncologic patients.MethodsBetween January 2013 and December 2015, 101 elderly oncological patients underwent right IJV CVP placement under ultrasound-guidance. The length of catheter introduction ranged from 18 to 21 cm. Intraoperative fluoroscopy (IF) was always performed intraoperatively. Chest X-ray (CXR) was always performed 30 min after the end of the procedure.ResultsThe morbidity rate was 1.98%; two arterial punctures were reported with one self-limiting hematoma. Two patients (1.98%) had catheter misplacements, recognized by intraoperative IF. No patients (0%) experienced pneumothorax (PNX), confirmed at CXR. Patients were all discharged at maximum 6 h from the procedure.DiscussionThe risk of catheter misplacement, PNX, and arterial/nerve puncture remains present with this technique. Lower rates of catheter misplacement have been reported after right IJV puncture, probably for its straight vertical course. Our results are in accordance with literature (1 counter-lateral subclavian vein and 1 counter-lateral internal jugular vein misplacements). All misplacements were detected intraoperatively. The PNX rates after cannulation of the IJV vary between 0.0 and 0.5%. We had no PNX occurrence.ConclusionUltrasonography (US) has improved safety and effectiveness of port system placements. While routine post-procedural CXR seems avoidable, IF should be considered mandatory.

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