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BOTTOM LINE
The single-incision technique for placing ports via the axillary vein is a feasible and safe procedure
with high technical success and low risk of complications.
MAJOR POINTS
Conventional techniques for placing catheters use two incisions to create a subcutaneous tunnel
with several associated drawbacks.
Potential advantages include cosmetic benefits, reduction of post-procedural discomfort, and easier
placement in patients with tracheostomies
Potential drawbacks include limited subcutaneous tunnel length, a potentially inaccessible IVJ, and
difficulty advancing devices.
CRITICISM
Port pocket location was not randomized because this was a retrospective review.
Patient follow-up and CT imaging were inconsistent, and follow-up period was generally short.
Comparison to a control group, port placement using the traditional two incision technique, was not
made.
Study design
IRB-approved retrospective study
INCLUSION CRITERIA
EXCLUSION CRITERIA
Purpose
To evaluate the technical feasibility and safety of a single-incision technique for placement of
implantable venous access ports via the axillary vein
Intervention
Ports were placed in 112 men and 104 women with a mean age of
58.2 years
Ports were placed via the left axillary vein in 172 patients and via the
right axillary vein in 44 patients
The most common reason for placing a right-sided port was
left-sided breast cancer (n=25)
Procedure time
Fluoroscopy time
Outcome
All procedures using single-incision technique were successful, with a mean fluoroscopy time
of 0.65 minutes and mean procedure time of nearly 14 minutes.
The most common final needle tip location was overlapping the first rib on fluoroscopic
imaging
On CT scan, the entry points into the vein was the axillary vein in 161 patients and the
subclavian vein in 31 patients.
Most common problem encountered was advancement of the wire or catheter into unintended
veins, which occurred in 33 patients
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