Clinical application of ultrasound-guided totally implantable venous access ports implantation via the posterior approach of the internal jugular vein - feasible, safe, and effective

Sep 29, 2026

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Background: Determine feasibility and safety of ultrasound-guided implantation of totally implantable venous access ports (TIVAPs) via the posterior approach of the internal jugular vein (IJV). Methods: From Sep 2021 to Aug 2022, 88 oncology patients underwent ultrasound-guided TIVAP placement; catheter tips were fluoroscopically positioned at the cavoatrial junction. Surgical success, first-attempt success, and intra/postoperative complications were collected and analyzed. Results: 100% surgical success; first-attempt success 96.59%; no intraoperative complications; postoperative complications 4.55% with mainly infection, fibrin sheath, and port flip. Conclusion: The posterior approach is feasible and safe with low complication rates and improved comfort and cosmetic appearance.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

INTRODUCTION

TIVAP background and implantation approaches

Rationale for posterior approach and aesthetic/comfort considerations

METHODS AND OUTCOMES

Patient cohort and procedural workflow

Catheter positioning and complication assessment

RESULTS

Surgical success and first-attempt success

Operative time and intraoperative complications

Postoperative complications and follow-up

CONCLUSION

J Chin MedAssoc Original article Clinical application of ultrasound-guided totally implantable venous access ports implantation via the posterior approach of the internal jugular vein Minghai Wanga, Linna Tangb, Rongwei Xua,* , Shiyong Qina, Shuguang Zhanga aDepartment of General Surgery, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China; bDepartment of Hospital Infection Control, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China Abstract Background: To determine the feasibility and safety of ultrasound-guided totally implantable venous access port (TIVAP) implantation via the posterior approach of the internal jugular vein (IJV) . Methods: From September 2021 to August 2022, 88 oncology patients underwent ultrasound-guided implantation of TIVAPs via the posterior approach of the IJV for the administration of chemotherapy. The catheter tip was adjusted to be positioned at thecavoatrial junction under fluoroscopic guidance. Clinical data including surgical success, success rate for the first attempt, intraoperative, and postoperative complications were all collected and analyzed. Results: All patients underwent successful surgery (100%), whereby 58 were via the right IJV and 30 via the left IJV, and the success rate for the first attempt was 96.59%(85/88) . The operation time was 20 to 43 minutes, with an average of 26.59 ± 6.18 minutes with no intraoperative complications. The follow-up duration ranged from 1 to 12 months (mean = 5.28 ± 3.07) and the follow-up rate was 100% . The rate of postoperative complications was 4.55%(4/88), including port-site infection in two cases, fibrin sheath formation in one case, and port flip in one case. No other complications were observed during follow-up. Conclusion: Ultrasound-guided TIVAP implantation via the posterior approach of the IJV is feasible, safe, and effective, with a low rate of intraoperative and postoperative complications. Not only was the curvature of the catheter device smooth, but patients were satisfied with the comfort and cosmetic appearance. Additionally, we could reduce the possible complications of pinching and kinking of the catheter by using this approach. Therefore, further large-sample, prospective, and randomized controlled trials are warranted. Keywords: Complications; Internal jugular vein; Posterior approach; Totally implantable venous access ports; Ultrasound-guided 1. INTRODUCTION Because Niederhuber et al1 first introduced totally implantable venous access ports (TIVAPs) at the MD Anderson Cancer Center in 1982, they have gained worldwide popularity in oncology for long-term chemotherapy infusions, hydration, parenteral nutrition, and serial blood withdrawals.2,3 Compared with peripherally inserted central catheters (PICCs), TIVAPs allow for the long-term administration of venotoxic compounds, reduce the risk of infection and thrombosis, and alleviate the burden of intravenous therapy, thereby significantly improving quality of life.4–6 The implantation of TIVAPs can be performed using different methods, such as percutaneous insertion and surgical * Address correspondence. Dr. Rongwei Xu, Department of General Surgery, The First Affiliated Hospital to Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766, Jingshi Road, Jinan 250014, Shandong, [China. E-mail address: xrwei2003@126.com](China. E-mail address: xrwei2003@126.com) (R. Xu). Author contributions: Dr Minghai Wang and Dr Linna Tang contributed equally to this work. Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2024) 87: 126-130. Received February 21, 2023; accepted July 9, 2023. doi: 10. 1097/JCMA.0000000000001030 Copyright © 2023, the Chinese Medi

FAQs

What question does the study address?

The study evaluates whether ultrasound-guided TIVAP implantation via the posterior approach of the internal jugular vein is feasible and safe.

How were the catheter tips positioned during the procedure?

Catheter tips were adjusted to the cavoatrial junction under fluoroscopic guidance.

What were the key findings on success and complications?

All 88 patients had successful surgery (100%), with a first-attempt success rate of 96.59% and no intraoperative complications. Postoperative complications occurred in 4.55%, including port-site infection (2 cases), fibrin sheath formation (1 case), and port flip (1 case).

Sep 29, 2026

Uploaded by Levi