This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Di Carlo, I. Articles by Cordio, S. Search for Related Content PubMed PubMed Citation Articles by Di Carlo, I. Articles by Cordio, S.

External Jugular Vein Cutdown Approach, as a Useful Alternative, Supports the Choice of the Cephalic Vein for Totally Implantable Access Device Placement

¹ Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Via Messina, 829, 95126 Catania, Italy
² Department of Oncology, Garibaldi Hospital, 95100 Catania, Italy

Correspondence: Address correspondence and reprint requests to: Isidoro Di Carlo, MD, PhD; E-mail: idicarlo{at}unict.it

Background: Cephalic vein (CV) cut down for totally implantable venous access device (TIVAD) placement has been accepted as an alternative to the percutaneous subclavian vein approach. The aim of this retrospective study was to validate the external jugular vein (EJV) cut-down approach when the CV is not feasible.

Methods: Patients receiving a TIVAD from January 1995 to December 2003 were included in this study. Age, sex, surgical technique, disease, device used, length of the procedure, and morbidity were considered.

Results: A total of 427 TIVADs were placed in 425 patients: 253 men (59.5%) and 172 women (40.5%) aged 31 to 79 years. Of 425 patients, 5 were excluded; 420 underwent a CV cut down on the first attempt, and 391 (93.1%) procedures were successful. Among the final 29 patients, 20 (68.96%) underwent a TIVAD placement through the ipsilateral EJV cut-down approach. In the remaining nine patients (31.04%), TIVAD placement was performed through the ipsilateral internal jugular vein in four cases, via the ipsilateral axillary vein in three cases, and through the ipsilateral coracobrachial vein in the other cases. No immediate postoperative complications were detected in any of the patients.

Conclusions: TIVAD placement by the CV cut-down approach is safe and fast, and its success rate is very high. By avoiding the immediate complications associated with the percutaneous approach, the EJV cut down has to be considered a valid, safe, and suitable alternative when the CV is not feasible.

Key Words: Totally implantable venous access device • Chronic indwelling central venous access • Venous access • Cephalic vein • Internal jugular vein

This article has been cited by other articles:

				R. Biffi, F. Orsi, S. Pozzi, U. Pace, G. Bonomo, L. Monfardini, P. Della Vigna, N. Rotmensz, D. Radice, M. G. Zampino, et al. Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial Ann. Onc., May 1, 2009; 20(5): 935 - 940. [Abstract] [Full Text] [PDF]