RADIOLOGIC PLACEMENT OF SUBCUTANEOUS INFUSION CHEST PORTS FOR LONG-TERM CENTRAL VENOUS ACCESS

OBJECTIVE. The technical success and complications associated with rad iologic placement of subcutaneous implantable chest ports for long-ter m central venous access were evaluated, MATERIALS AND METHODS. Between May 1, 1996, and December 31, 1996, 80 chest ports were placed in 80 consecutive patients using the right internal jugular vein as the pref erred access route. All procedures occurred in interventional radiolog y suites with patients receiving conscious sedation. Both sonography a nd fluoroscopy were used for venipuncture and to guide port insertion. Follow-up was obtained by the clinical service and by performing char t reviews electronically. RESULTS. Technical success was 100%, and fol low-up was obtained in all patients. One procedural complication occur red that was unrelated to actual catheter placement, Mean catheter use was 155 days (total, 12,168 days; range, 18-303 days), Confirmed cath eter-related infection rate was 3%, or 0.016 per 100 access days; symp tomatic catheter-related central venous thrombosis rate was 1%, or 0.0 08 per 100 access days; and 5% of catheters were removed prematurely. No instances of hematoma formation, catheter tip migration or malposit ion, symptomatic air embolism, spontaneous catheter fracture, or pneum othorax were found, CONCLUSION, With the benefit of both sonographic a nd fluoroscopic guidance, subcutaneous implantable chest ports can be inserted by radiologists with equal or lower complication rates than t hose reported in surgical series, Image-guided insertion of chest port s should replace rather than supplement unguided placement.