title: Ultrasound-Guided Radiological Placement of Central Venous Port via the Subclavian Vein: A Retrospective Analysis of 500 Cases at a Single Institute.
abstract: The purpose of this study was to assess the technical success rate and adverse events (AEs) associated with ultrasound (US)-guided radiological placement (RP) of a central venous port (CVP) via the subclavian vein (SCV). Between April 2006 and May 2007, a total of 500 US-guided RPs of a CVP via the SCV were scheduled in 486 cancer patients (mean age +/- SD, 54.1 +/- 18.1 years) at our institute. Referring to the interventional radiology report database and patients' records, technical success rate and AEs relevant to CVP placement were evaluated retrospectively. The technical success rate was 98.6% (493/500). AEs occurred in 26 cases (5.2%) during follow-up (range, 1-1080 days; mean +/- SD, 304.0 +/- 292.1 days). AEs within 24 h postprocedure occurred in five patients: pneumothorax (n = 2), arterial puncture (n = 1), hematoma formation at the pocket site (n = 2), and catheter tip migration into the internal mammary vein (n = 1). There were seven early AEs: hematoma formation at the pocket site (n = 2), fibrin sheath formation around the indwelling catheter (n = 2), and catheter-related infections (n = 3). There were 13 delayed AEs: catheter-related infections (n = 7), catheter detachments (n = 3), catheter occlusion (n = 1), symptomatic thrombus in the SCV (n = 1), and catheter migration (n = 1). No major AEs, such as procedure-related death, air embolism, or events requiring surgical intervention, were observed. In conclusion, US-guided RP of a CVP via the SCV is highly appropriate, based on its high technical success rate and the limited number of AEs.
authors.affiliation: Division of Diagnostic Radiology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, 104-0045 Tokyo, Japan.  nosakamoto@hotmail.co.jp
authors.forename: Notiaki
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arai
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Mahahide
authors.initials: M
authors.lastname: Takahashi
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Tsurusaki
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimuta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D013350:Subclavian Vein; D018084:Ultrasonography, Interventional