Ultrasound Guided Port-A-Cath Implantation

DOI: 10.4236/ss.2014.54028   PDF   HTML     3,433 Downloads   4,933 Views  


Purpose: The use of port catheters is well accepted in the management of patients with malignancy. In this study, we compare the technical success and the complication rates of ultrasound guided Port-A-Cath implantation with doing this procedure by using the anatomical landmark method. Methods: In a retrospective study, from 2006 to 2009, medical files of 104 patients who had undergone Port-A-Cath implantation were reviewed. The indication for port catheter implantation was malignancy in all cases. Among our patients, Port-A-Cath implantation was done in 63 patients by using landmark method and in 41 patients by guidance of ultrasound. All patients had been observed for complications including pain, port infection, and port thrombus, thrombus of central veins, skin necrosis, and success in using of Port-A-Cath for at least one month following the procedure, in the vascular clinic. Results: in landmark method group, 2 catheters were non-functional just after placement (3.2%) while all Port-A-Caths in ultrasound-guided group were functional. Ten patients (15.9%) in land mark group and 1 patient (2.4%) in ultrasound-guided group were complicated. The difference between complication rate in anatomic landmarks method and ultrasound-guided method was statistically significant (p < 0.04). There was no significant difference in two groups in duration of port placement (p < 0.345), age (p < 0.444), site of port placement (p < 0.244) or type of malignancy (p < 0.18). Conclusion: Considering high rate of success and low complications in placement of Port-A-Cath with ultrasound guidance, this method is superior to the land mark method in patients with malignancy.

Share and Cite:

Hemmati, H. , Delshad, M. , Barzegar, M. , Jandaghi, A. , Najafi, B. , Asgary, M. and Es-Haghi, A. (2014) Ultrasound Guided Port-A-Cath Implantation. Surgical Science, 5, 159-163. doi: 10.4236/ss.2014.54028.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Brothers, T.E., VonMoll, L.K., Niederhuber, J.E., et al. (1988) Experience with Subcutaneous Infusion Ports in Three Hundred Patients. Surgery, Gynecology & Obstetrics, 166, 295-301.
[2] Galloway, M. (2010) Insertion and Placement of Central Catheters in the Oncology Patient. Seminars in Oncology Nursing, 26, 102-112. http://dx.doi.org/10.1016/j.soncn.2010.02.004
[3] Tercan, F., Ozkan, U. and Oguzkurt, L. (2008) US-Guided Placement of Central Vein Catheters in Patients with Disorders of Hemostasis. European Journal of Radiology, 65, 253-256.
[4] Vandonia, R.E., et al. (2009) Randomised Comparison of Complications from Three Different Permanent Central Venous Access Systems. Swiss Medical Weekly, 139, 313-316
[5] Mumtaz, H., et al. (2001) Central Venous Catheter Placement in Patients with Disorders of Hemostasis. The American Journal of Surgery, 180, 503-506. http://dx.doi.org/10.1016/S0002-9610(00)00552-3
[6] Vescia, S., et al. (2008) Management of Venous Port Systems in Oncology: A Review of Current Evidence. Annals of Oncology, 19, 9-15.
[7] Froehlich, C.D., et al. (2009) Ultrasound-Guided Central Venous Catheter Placement Decreases Complications and Decreases Placement Attempts Compared with the Landmark Technique in Patients in a Pediatric Intensive Care Unit. Pediatric Critical Care, 37, 1090-1096.
[8] Coccaro, M., Bochicchio, A.M., Capobianco, A.M., Di Leo, P., Mancino, G. and Cammarota, A. (2001) Long-Term Infusional Systems: Complications in Cancer Patients. Tumori, 87, 308-311.
[9] Poorter, R.L., Lauw, F.N., Bemelman, W.A., Bakker, P.J., Taat, C.W. and Veenhof, C.H. (1996) Complications of an Implantable Venous Access Device (Port-A-Cath) during Intermittent Continuous Infusion of Chemotherapy. European Journal of Cancer, 32, 2262-2266.
[10] Niederhuber, J.E., Ensminger, W., Gyves, J.W., Liepman, M., Doan, K. and Cozz, E. (1982) Totally Implanted Venous and Arterial Access System to Replace External Catheters in Cancer Treatment. Surgery, 92, 706-711.
[11] Ku, Y., Kuo, P., Tsai, Y., Huang, W., Lin, M. and Tsao, C. (2009) Port-A-Cath Implantation Using Percutaneous Puncture without Guidance. Annals of Surgical Oncology, 16, 729-734.
[12] Palepu, G.B., Deven, J., Subrahmanyam, M. and Mohan, S. (2009) Impact of Ultrasonography on Central Venous Catheter Insersion in Intensive Care. Indian Journal of Radiology and Imaging, 19, 3.
[13] Arul, G.S., Lewis, N., Bromley, P. and Bennett, J. (2009) Ultrasound-Guided Percutaneous Insertion of Hickman Lines in Children. Prospective Study of 500 Consecutive Procedures. Journal of Pediatric Surgery, 44, 1371-1376. http://dx.doi.org/10.1016/j.jpedsurg.2008.12.004
[14] Chuan, W., Wei, W. and Yu, I. (2005) A Randomized-Controlled Study of Ultrasound Prelocation vs Anatomical Landmark-Guided Cannulation of the Internal Jugular Vein in Infants and Children. Paediatric Anaesthesia, 15, 733-738.
[15] Balls, A., LoVecchio, F., Kroeger, A., Stapczynski, J.S., Mulrow, M. and Drachman, D. (2010) Ultrasound Guidance for Central Venous Catheter Placement: Results from the Central Line Emergency Access Registry Database. American Journal of Emergency Medicine, 28, 561-567.
[16] Gallieni, M., Pittiruti, M. and Biffi, R. (2008) Vascular Access in Oncology Patients. CA: A Cancer Journal for Clinicians, 58, 323-346. http://dx.doi.org/10.3322/CA.2008.0015
[17] Kusminsky, R.E. (2007) Complications of Central Venous Catheterization. Journal of the American College of Surgeons, 204, 681-696.
[18] Lewis, C.A., et al. (2003) Quality Improvement Guidelines for Central Venous Access. Journal of Vascular and Interventional Radiology, 14, 231-235.
[19] Beckers, M., Ruven, H., Seldenrijk, C.A., Prins, M.H. and Biesma, D.H. (2010) Risk of Thrombosis and Infections of Central Venous Catheters and Totally Implanted Access Ports in Patients Treated for Cancer. Thrombosis Research, 125, 318-321. http://dx.doi.org/10.1016/j.thromres.2009.06.008
[20] Nosher, J.L., et al. (2001) Radiologic Placement of a Low Profile Implantable Venous Access Port in a Pediatric Population. Cardio Vascular and Interventional Radiology, 24, 395-399.
[21] Yip, D. and Funaki, B. (2002) Subcutaneous Chest Ports via the Internal Jugular Vein. Acta Radiologica, 43, 371-375.
[22] Gebauer, B., Teichgräber, U., Werk, M., Beck, A. and Wagner, H. (2008) Sonographically Guided Venous Puncture and Fluoroscopically Guided Placement of Tunneled, Large-Bore Central Venous Catheters for Bone Marrow Transplantation—High Success Rates and Low Complication Rates. Supportive Care in Cancer, 16, 897-904. http://dx.doi.org/10.1007/s00520-007-0378-9
[23] Karakitsos, D., et al. (2006) Real-Time Ultrasound-Guided Catheterization of the Internal Jugular Vein: A Prospective Comparison with the Landmark Technique in Critical Care Patients. Critical Care, 10, 6.
[24] Koroglu, M., et al. (2006) Percutaneous Placement of Central Venous Catheters: Comparing the Anatomical Landmark Method with the Radiologically Guided Technique for Central Venous Catheterization through the Internal Jugular Vein in Emergent Hemodialysis Patients. Acta Radiologica, 47, 43-47. http://dx.doi.org/10.1080/02841850500406845
[25] Denys, B.G., Uretsky, B.F. and Reddy, P.S. (1993) Ultrasound-Assisted Cannulation of the Internal Jugular Vein. A Prospective Comparison to the External Landmark-Guided Technique. Circulation, 87, 1557-1562. http://dx.doi.org/10.1161/01.CIR.87.5.1557
[26] Gebauer, B., El-Sheik, M., Vogt, M. and Wagner, H. (2009) Combined Ultrasound and Fluoroscopy Guided Port Catheter Implantation—High Success and Low Complication Rate. European Journal of Radiology, 69, 517-522. http://dx.doi.org/10.1016/j.ejrad.2007.10.018
[27] Miller, A.H., Roth, B.A., Mills, T.J., Woody, J.R., Longmoor, C.E. and Foster, B. (2002) Ultrasound Guidance versus the Landmark Technique for the Placement of Central Venous Catheters in the Emergency Department. Academic Emergency Medicine, 9, 800-805.
[28] McGee, D.C. and Gould, M.K. (2003) Preventing Complications of Central Venous Catheterization. The New England Journal of Medicine, 348, 1123-1133.

comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.