Clinical application of ultrasound combined with DSA-guided implantation of totally implantable venous access port via upper arm vein approach in chemotherapy for patients with malignant tumors
10.3969/j.issn.1008-794X.2024.07.007
- VernacularTitle:超声联合DSA引导下经上臂静脉输液港植入术在恶性肿瘤化疗患者中的临床应用研究
- Author:
Guangxin JIN
1
;
Fangqin ZHANG
;
Yawen WANG
;
Yan GUO
;
Xiaoxia QIU
;
Xuebin ZHANG
Author Information
1. 200127 上海 上海交通大学医学院附属仁济医院肿瘤介入科
- Keywords:
ultrasound;
DSA guidance;
upper arm vein;
totally implantable venous access port;
complication
- From:
Journal of Interventional Radiology
2024;33(7):733-737
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the technical feasibility and safety of upper arm vein approach in the implantation of totally implantable venous access port(TIVAP)under the guidance of ultrasound combined with DSA.Methods The clinical data of 1 546 patients with malignant tumors,who received TIVAP implantation via upper arm vein access under the guidance of ultrasound combined with DSA at the Affiliated Renji Hospital,School of Medicine of Shanghai Jiao Tong University of China between January 2020 and January 2022,were retrospectively analyzed.The implantation success rate,single-puncturing success rate,operation time,and complications were compared between the PICC catheterization room and the DSA operating room.Results The technical success rate in the 1546 patients was 100％,with a single-puncturing success rate of 99.48％.In 766 patients the TIVAP implantation was performed in the PICC catheterization room(PICC group),and in 780 patients the TIVAP implantation was carried out in the DSA operating room(DSA group).The mean operation time in the DSA group was(20.1±1.3)min,which was obviously shorter than(25.4±1.9)min in the PICC group,and the incidence of primary catheter misplacement in the DSA group was 0％,which was remarkably lower than 0.78％in the PICC group(P＜0.05).No statistically significant differences in the incidences of complications,including infection,thrombosis,upper limb movement disorder,catheter occlusion,exposure of infusion port body,and overturn of infusion port body,existed between the two groups(P＞0.05).Conclusion Ultrasound-guided TIVAP via upper arm vein approach is a safe and effective infusion route for patients with malignancy receiving chemotherapy.The combination use of ultrasound guidance and intraoperative DSA guidance can reduce the operation time as well as the incidence of operation-related complications.
