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- Title
Ultrasound-guided infraclavicular axillary vein puncture is effective to avoid pinch-off syndrome: a long-term follow-up study.
- Authors
Osawa, Hideki; Hasegawa, Junichi; Yamakawa, Kazuma; Matsunami, Nobuki; Mikata, Shoki; Shimizu, Junzo; Kim, Yong; Morishima, Hirotaka; Hirota, Masaki; Souma, Yoshihito; Kim, Ho; Sawada, Genta; Nezu, Riichiro
- Abstract
Purpose: Pinch-off syndrome (POS) is a serious complication encountered during the long-term management of totally implantable access ports (TIAPs). The aim of this study was to examine the effect of ultrasound-guided infraclavicular axillary vein puncture to avoid POS in patients with long-term use of a TIAP. Methods: This was a retrospective review of 207 consecutive TIAPs: one hundred devices implanted using an anatomical landmark technique were used as historical controls (Landmark group), while 107 devices were implanted using an ultrasound (US)-guided puncture method (US group). The pinch-off grade (POG) was determined using chest X-ray findings following the definition of Hinke, and the progression of POG during the follow-up period of the Landmark and US groups was compared. Results: Sixteen cases in the Landmark group were POG-1 and 3 were POG-2, while all cases in the US group were POG-0 at the time of venipuncture ( p < 0.001). Eleven patients in the Landmark group showed some degree of progression of the POG during the follow-up period. In contrast, there were no cases showing progression of the POG in the US group ( p = 0.002). Conclusions: US-guided infraclavicular axillary vein puncture was found to effectively make it possible to avoid POS for the long-term management of TIAPs, as well as at the time of implantation.
- Subjects
ULTRASONIC imaging; CHEST X rays; VENOUS puncture; CANCER chemotherapy; INTRAVENOUS therapy
- Publication
Surgery Today, 2013, Vol 43, Issue 7, p745
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-012-0309-3