title: Upper arm central venous port implantation: a 6-year single institutional retrospective analysis and pictorial essay of procedures for insertion.
abstract: BACKGROUND
  The requirement of central venous (CV) port implantation is increasing with the increase in the number of cancer patients and advancement in chemotherapy. In our division, medical oncologists have implanted all CV ports to save time and consultation costs to other departments. Recently, upper arm implantation has become the first choice as a safe and comfortable method in our unit. Here we report our experience and discuss the procedure and its potential advantages.
  
  
  METHODS
  All CV port implantations (n = 599) performed in our unit from January 2006 to December 2011 were analyzed. Procedural success and complication rates between subclavian and upper arm groups were compared.
  
  
  RESULTS
  Both groups had similar patient characteristics. Upper arm CV port and subclavian implantations were equivalently successful and safe. Although we only retrospectively analyzed data from a single center, the upper arm group had a significantly lower overall postprocedural complication rate than the subclavian group. No pneumothorax risk, less risk of arterial puncture by ultrasound, feasibility of stopping potential arterial bleeding, and prevention of accidental arterial cannulation by targeting the characteristic solitary basilic vein were the identified advantages of upper arm CV port implantation. In addition to the aforementioned advantages, there is no risk of "pinch-off syndrome," possibly less patient fear of manipulation, no scars on the neck and chest, easier accessibility, and compatibility with the "peripherally inserted central catheter" technique.
  
  
  CONCLUSIONS
  Upper arm implantation may benefit clinicians and patients with respect to safety and comfort. We also introduce our methods for upper arm CV port implantation with the videos.
authors.affiliation: Department of Clinical Oncology, Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Shiono
authors.affiliation: Department of Clinical Oncology, Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Clinical Oncology, Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Japan; Department of Clinical Oncology, Institute of Development, Aging, and Cancer, Tohoku University, Aoba-ku, Sendai, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kakudo
authors.affiliation: Department of Clinical Oncology, Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Clinical Oncology, Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimodaira
authors.affiliation: Department of Clinical Oncology, Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Japan; Department of Clinical Oncology, Institute of Development, Aging, and Cancer, Tohoku University, Aoba-ku, Sendai, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Clinical Oncology, Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Japan; Department of Clinical Oncology, Institute of Development, Aging, and Cancer, Tohoku University, Aoba-ku, Sendai, Japan.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Ishioka
mesh_terms: D001132:Arm / Q000098:blood supply*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014465:Ultrasonics