title: Totally implantable venous catheters: insertion via internal jugular vein with pocket implantation in the arm is an alternative for diseased thoracic walls.
abstract: OBJECTIVE
  Insertion of totally implantable catheters via deep vessels that drain into the superior vena cava results in a lower incidence of venous thrombosis and infection as compared to catheters inserted into femoral and arm veins. Superior vena cava obstruction and inadequacy of the thoracic wall are conditions that prevent reservoir implantation in the chest wall. In this article, we describe a technical innovation that enables the pocket to be fixed in the arm while still allowing access to be achieved via the internal jugular vein.
  
  
  METHODS
  The procedure reported maintains the use of the internal jugular vein for access even when the patient's chest is not suited for reservoir implantation, which is localized in the arm.
  
  
  RESULTS
  The procedure was successful and no complications occurred. The position of the catheter tip did not alter with arm movement.
  
  
  CONCLUSIONS
  The implantation of a port reservoir in the arm following venous access via the internal jugular vein is both safe and convenient.
authors: Vascular and Endovascular Surgery Division, São Paulo University Medical School, São Paulo, Brazil. aezerati@uol.com.br
authors: Antonio Eduardo
authors: AE
authors: Zerati
authors: Nelson
authors: N
authors: Wolosker
authors: Joaquim Maurício
authors: JM
authors: da Motta-Leal-Filho
authors: Pedro Henrique Xavier
authors: PH
authors: Nabuco
authors: Pedro
authors: P
authors: Puech-Leão
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001132:Arm / Q000601:surgery*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000379:methods*; D002408:Catheters, Indwelling; D004867:Equipment Design; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D011859:Radiography; D035441:Thoracic Wall / Q000473:pathology*; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents