title: Ultrasound-Guided Placement of Central Venous Port Systems via the Right Internal Jugular Vein: Are Chest X-Ray and/or Fluoroscopy Needed to Confirm the Correct Placement of the Device?
abstract: Percutaneous central venous port (CVP) placement using ultrasound-guidance (USG) via right internal jugular vein is described as a safe and effective procedure. The aim of this study is to determine whether intraoperative fluoroscopy (IF) and/or postoperative chest X-ray (CXR) are required to confirm the correct position of the catheter.
  
  
  
  Between January 2012 and December 2014, 302 adult patients underwent elective CVP system placement under USG. The standard venous access site was the right internal jugular vein. The length of catheter was calculated based on the height of the patient. IF was always performed to confirm US findings.
  
  
  
  176 patients were men and 126 were women and average height was 176.2 cm (range 154-193 cm). The average length of the catheter was 16.4 cm (range 14-18). Catheter malposition and pneumothorax were observed in 4 (1.3 %) and 3 (1 %) patients, respectively. IF confirmed the correct position of the catheter in all cases. Catheter misplacement (4 cases) was previously identified and corrected on USG. Our rates of pneumothorax are in accordance with those of the literature (0.5-3 %).
  
  
  
  Ultrasonography has resulted in improved safety and effectiveness of port system implantation. The routine use of CXR and IF should be considered unnecessary.
authors.affiliation: First Department of Surgery, Sapienza University Medical School, Rome, Italy. michelangelo.miccini@uniroma1.it.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Miccini
authors.affiliation: Department of Surgery, "Abano Terme" Hospital, Abano Terme, Padua, Italy.
authors.forename: Diletta
authors.initials: D
authors.lastname: Cassini
authors.affiliation: First Department of Surgery, Sapienza University Medical School, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Gregori
authors.affiliation: Department of Anaesthesiology, Sapienza University Medical School, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Gazzanelli
authors.affiliation: First Department of Surgery, Sapienza University Medical School, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Cassibba
authors.affiliation: First Department of Surgery, Sapienza University Medical School, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Biacchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D057785:Catheters; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D014965:X-Rays