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KMID : 0604020150300010013
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Korean Journal of Critical Care Medicine
2015 Volume.30 No. 1 p.13 ~ p.17
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Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access
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Jung Pil-Young
Ryu Hoon
Jung Jae-Hung
Lee Eun-Bi
Oh Joong-Hwan
Byun Chun-Sung
Park Il-Hwan
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Abstract
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Background: Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allowspatients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP relatedcomplications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava.
Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach(Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzedto compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access tosuperior vena cava.
Results: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax(n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8,4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complicationsexcept infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complicationfree probability is significantly higher in group 1 (p = 0.040).
Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of highincidence of mechanical complication, such as pinch-off syndrome.
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KEYWORD
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jugular vein, subclavian vein, vascular access, vascular access devices
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