Ultrasound-guided infraclavicular axillary vein puncture is effective to avoid pinch-off syndrome: a long-term follow-up study

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• 作者：Hideki Osawa (1)
  Junichi Hasegawa (1)
  Kazuma Yamakawa (2)
  Nobuki Matsunami (1)
  Shoki Mikata (1)
  Junzo Shimizu (1)
  Yong Kook Kim (1)
  Hirotaka Morishima (1)
  Masaki Hirota (1)
  Yoshihito Souma (1)
  Ho Min Kim (1)
  Genta Sawada (3)
  Riichiro Nezu (1)
  
• 关键词：Chemotherapy ; Totally implantable access port ; Pinch ; off syndrome ; Ultrasound ; guided puncture
• 刊名：Surgery Today
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：43
• 期：7
• 页码：745-750
• 全文大小：565KB
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• 作者单位：Hideki Osawa (1)
  Junichi Hasegawa (1)
  Kazuma Yamakawa (2)
  Nobuki Matsunami (1)
  Shoki Mikata (1)
  Junzo Shimizu (1)
  Yong Kook Kim (1)
  Hirotaka Morishima (1)
  Masaki Hirota (1)
  Yoshihito Souma (1)
  Ho Min Kim (1)
  Genta Sawada (3)
  Riichiro Nezu (1)
  
  1. Department of Surgery, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
  2. Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
  3. Department of Surgical Oncology, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Fukuoka, Japan
  
• ISSN：1436-2813

文摘

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.