title: A single-center study of vascular access sites for intravenous ports.
abstract: OBJECTIVE
  This study evaluated the use of intravenous ports and provides a guide related to clinical decision making.
  
  
  METHODS
  This study retrospectively reviewed 1505 patients who had received intravenous ports at Chang Gung Memorial Hospital in 2006. The relationships between the complications and entry routes were assessed. The intervention-free periods were also determined and compared. The patients were followed up until June 2010.
  
  
  RESULTS
  Of the 1543 procedures performed, 412 were reinterventions to treat complications, most of which corresponded to fewer than 0.1 episodes per 1000 catheter-days; these were not associated with any particular entry route. There was a higher catheter fracture rate when the right subclavian vein was chosen as the entry vessel (p < 0.05). The intervention-free period ranged from 207 to 533 days.
  
  
  CONCLUSIONS
  The subclavian vein is not recommended for the use of intravenous ports. There is not only a higher risk of iatrogenic pneumothorax or hemothorax using this entry route but also a higher fracture rate, which may be caused by pinch-off syndrome. The greater saphenous vein should only be considered when the patient has superior vena cava syndrome. However, a higher incidence of infection and a lower device survival rate should be expected with this location.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Shing Street, Kueishan, 333, Taoyuan, Taiwan.
authors.forename: Ching-Feng
authors.initials: CF
authors.lastname: Wu
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
authors.forename: Ching-Yang
authors.initials: CY
authors.lastname: Wu
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
authors.forename: Tsung-Chi
authors.initials: TC
authors.lastname: Kao
authors.forename: Sheng-Yueh
authors.initials: SY
authors.lastname: Yu
authors.forename: Hao-Jui
authors.initials: HJ
authors.lastname: Li
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Hsieh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006491:Hemothorax / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007223:Infant; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012306:Risk; D012501:Saphenous Vein; D013350:Subclavian Vein; D013577:Syndrome; D062666:Vascular Access Devices / Q000009:adverse effects / Q000706:statistics & numerical data; D014683:Vena Cava, Superior; D055815:Young Adult