A prospective evaluation on external jugular vein cut-down approach for TIVAD implantation.
BACKGROUND
Totally implantable venous access devices can be implanted both by percutaneous approaches and by surgical approaches with cephalic vein or external jugular vein cut-down techniques that are related to low intraoperative complication rates. The authors report a prospective evaluation of 83 consecutive external jugular vein cut-down approaches for totally implantable venous access devices implantation.


METHODS
Eighty three consecutive patients (28 M, 55 F, mean age 54.2) suffering from solid tumors (58) or hematologic diseases (25) were consecutively submitted to totally implantable venous access devices insertion through external jugular vein cut-down approach (75 on right side, 8 on left side).


RESULTS
All devices were surgically implanted; no instances of intraoperative complications were detected. After a minimum follow-up of 150 days, only one case of wound hematoma and one case of device malfunction due to incorrect catheter angulation were noted. Postoperative patient satisfaction was evaluated by the use of specific questionnaire that demonstrated a good satisfaction and compliance (92.8%) of patients with implanted devices.


CONCLUSIONS
Despite the lack of controlled studies comparing external jugular vein cut-down approach vs other approaches, this approach should be considered as a tool for long-term central vein catheters positioning, both as an alternative and for primary approach.
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy. giuseppe.cavallaro@uniroma1.it.
Giuseppe
G
Cavallaro
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Olga
O
Iorio
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Angelo
A
Iossa
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Francesco
F
De Angelis
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Marcello
M
Avallone
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Matteo
M
Massaro
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Consalvo
C
Mattia
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Gianfranco
G
Silecchia
D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D018579:Patient Selection; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors