• C P Lin, Y C Wang, F S Lin, C H Huang, and W Z Sun.
• Department of Anesthesiology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan. cplin0123@ntuh.gov.tw
• Eur J Surg Oncol. 2011 May 1; 37 (5): 448-51.

BackgroundPlacing a totally implantable venous access device (TIVAD) using the classical subclavian vein puncture method carries the risk of certain complications including hemothorax, pneumothorax and pinch-off syndrome. We set out to determine whether percutaneous axillary vein catheterization can decrease the incidence of these complications.MethodThis is a prospective, observational, uni-institutional study. We analyzed the outcome of 113 TIVADs performed by ultrasound-assisted percutaneous axillary vein catheterization from Jun. 2008 to Dec. 2008. Junior residents novice to subclavian and axillary vein catheterization performed the procedures. Insertion and indwelling catheter complications were recorded.ResultIn our study population, 100% of TIVAD placements were successful. 27 patients (23.9%) required 3 or more repeated punctures; only one patient (0.9%) had clinically insignificant pneumothorax. Neither arterial puncture nor brachial plexus injury was recorded in our study.ConclusionUltrasound-assisted percutaneous axillary vein catheterization for TIVAD is a safe and relatively simple method for inexperienced operators.Copyright © 2011 Elsevier Ltd. All rights reserved.

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