title: Ultrasound-assisted percutaneous catheterization of the axillary vein for totally implantable venous access device.
abstract: BACKGROUND
  Placing a totally implantable venous access device (TIVAD) using the classical subclavian vein puncture method carries the risk of certain complications including hemothorax, pneumothorax and pinch-off syndrome. We set out to determine whether percutaneous axillary vein catheterization can decrease the incidence of these complications.
  
  
  METHODS
  This is a prospective, observational, uni-institutional study. We analyzed the outcome of 113 TIVADs performed by ultrasound-assisted percutaneous axillary vein catheterization from Jun. 2008 to Dec. 2008. Junior residents novice to subclavian and axillary vein catheterization performed the procedures. Insertion and indwelling catheter complications were recorded.
  
  
  RESULTS
  In our study population, 100% of TIVAD placements were successful. 27 patients (23.9%) required 3 or more repeated punctures; only one patient (0.9%) had clinically insignificant pneumothorax. Neither arterial puncture nor brachial plexus injury was recorded in our study.
  
  
  CONCLUSIONS
  Ultrasound-assisted percutaneous axillary vein catheterization for TIVAD is a safe and relatively simple method for inexperienced operators.
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan. cplin0123@ntuh.gov.tw
authors.forename: C P
authors.initials: CP
authors.lastname: Lin
authors.forename: Y C
authors.initials: YC
authors.lastname: Wang
authors.forename: F S
authors.initials: FS
authors.lastname: Lin
authors.forename: C H
authors.initials: CH
authors.lastname: Huang
authors.forename: W Z
authors.initials: WZ
authors.lastname: Sun
mesh_terms: D001367:Axillary Vein / Q000000981:diagnostic imaging*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D006491:Hemothorax / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D011030:Pneumothorax / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D013350:Subclavian Vein; D014463:Ultrasonography