• Shin-Seok Yang and Moon Sang Ahn.
• Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
• Ann Vasc Surg. 2018 Jul 1; 50: 128-134.

BackgroundThe objective of the study was to evaluate the safety, technical feasibility, and complications of totally implanted venous access ports (TIVAPs) in the upper arm, for comparison with transjugular chest ports in patients with breast cancer.MethodsIn total, 223 consecutive female breast cancer patients who received a TIVAP in the upper arm or chest between July 2014 and February 2016 were included. All procedures were performed via a sonographic and fluoroscopic-guided approach using the Seldinger technique under local anesthesia. We reviewed the medical records to determine technical success, pain scale, and early (≤30 days) and late (>30 days) complications.ResultsIn total, 231 devices were implanted in the upper arms (n = 176, 76%) and chests (n = 55, 24%) of the patients. The mean age was 51.6 ± 10.7 years (range 23-78 years; upper arm, 52.1 ± 11.0 years; chest, 50.1 ± 9.7 years, P > 0.05). The mean implantation time for TIVAPs was 181.7 ± 109.2 days (range, 9-460 days; upper arm 175.2 ± 102.7 days; chest, 202.4 ± 126.6 days, P > 0.05), with 41,974 catheter days. The technical success rate was 100%. Fourteen complications (6.1%) occurred in 14 patients (0.33/1,000 catheter days). There was no significant difference in complication-free survival for patients with upper arm TIVAPs and those with transjugular chest TIVAPs. The mean amount of 2% lidocaine, used as local anesthesia, was 3.3 ± 1.7 mL and 14.5 ± 4.1 mL for upper arm and chest TIVAPs, respectively. (P < 0.001).ConclusionsImplantation of TIVAPs in the upper arm is a safe procedure with a low rate of complications. Upper arm TIVAPs can be implanted with less pain compared with transjugular chest TIVAPs.Copyright © 2018 Elsevier Inc. All rights reserved.

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