title: Evaluation of totally implantable central venous access devices with the cephalic vein cut-down approach: Usefulness of preoperative ultrasonography.
abstract: BACKGROUND
  The aims of this retrospective study, were to evaluate totally implantable central venous access device (TICVAD) implantation and to validate the efficacy of preoperative ultrasonography.
  
  
  METHODS
  A total of 380 cases implanted with TICVADs were divided into four groups: cut-downs with ultrasonography (group A, n = 112); cut-downs without ultrasonography (group B, n = 37); venous puncture (group C, n = 122); and replacements using the existing catheter (group D, n = 109). Operation time, completion rate, and complications were compared.
  
  
  RESULTS
  The average operating time was 41.7, 52.4, and 40.6 min in groups A, B (P < 0.01), and C, respectively. Group A and B experienced no postoperative pneumothorax, arterial puncture, or pinch-off syndrome. Completion rates were 93.7% in group A and 86.5% in group B. Preoperative ultrasonography identified the cephalic vein in 94.1% of subjects with an average diameter of 3.1 mm and depth of 10.2 mm. Identifying convergence of the cephalic vein and the axillary vein improved the completion rate.
  
  
  CONCLUSIONS
  This study showed that the cephalic vein cut-down approach for TICVAD implantation reduced complications. Preoperative ultrasonography resulted in a shorter operating time and higher completion rate.
authors.affiliation: Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.|Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Otsubo
authors.affiliation: Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Hatachi
authors.affiliation: Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Shibata
authors.affiliation: Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.|Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.|Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Hironosuke
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.|Department of Surgery, Nyuuwakai Oikawa Hospital, Fukuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Oikawa
authors.affiliation: Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yano
authors.affiliation: Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001367:Axillary Vein / Q000000981:diagnostic imaging* / Q000601:surgery; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging* / Q000601:surgery*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D057234:Preoperative Period; D012189:Retrospective Studies; D014463:Ultrasonography; D016748:Venous Cutdown / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents
keywords: cancer; indwelling catheter; totally implantable central venous access device; ultrasonography; venous cutdown