title: Factors that predict increased catheter tip movement in left internal jugular vein implantable venous access ports upon standing.
abstract: OBJECTIVE
  To determine the characteristics that predict catheter tip movement with positional changes in patients with left-sided, internal jugular vein (IJV) implantable venous access ports.
  
  
  METHODS
  A retrospective review revealed 264 patients with left IJV ports placed at one academic institution from 2008 to 2013 with follow-up upright chest radiographs. Demographic information was recorded and anatomic measurements were made on both procedural fluoroscopic imaging and upright chest radiographs. Multivariate regression analysis was performed to determine which factors had statistically significant relationships with catheter tip movement distance.
  
  
  RESULTS
  Mean catheter tip movement was 1.49 ± 1.97 cm. There was a statistically significant positive relationship between catheter tip movement distance and age (p = 0.03), body mass index (BMI) (p = 0.02), innominate vein angle (p<0.01) and dual- compared to single-lumen ports (p = 0.02). Port pocket location, venous access site and gender did not demonstrate statistical significance.
  
  
  CONCLUSIONS
  The factors associated with increased positional catheter tip movement for left IJV ports include patient age, BMI, innominate vein angle and dual- vs single-lumen port. This information can be useful in determining initial placement position and avoiding complications associated with catheter malposition.
authors.affiliation: Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina - USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Wallace
authors.forename: Esteban
authors.initials: E
authors.lastname: Afonso
authors.forename: Hyeon
authors.initials: H
authors.lastname: Yu
authors.forename: Katherine
authors.initials: K
authors.lastname: Birchard
authors.forename: Ari
authors.initials: A
authors.lastname: Isaacson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D004867:Equipment Design; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D009038:Motion; D015999:Multivariate Analysis; D056888:Patient Positioning; D010690:Phlebography; D011187:Posture; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult