Su Ta-Wei, Wu Ching-Feng, Fu Jui-Ying, Ko Po-Jen, Yu Sheng-Yueh, Kao Tsung-Chi, Hsieh Hong-Chang, Wu Ching-Yang
From the Division of Thoracic and Cardiovascular Surgery (TWS, CFW, PJK, SYY, TCK, HCH, CYW), Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University; and Division of Chest and Critical care (JYF), Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan, Taiwan.
Medicine (Baltimore). 2015 May;94(17):e728. doi: 10.1097/MD.0000000000000728.
An entry vessel is crucial for intravenous port implantation. A safe alternative entry vessel that can be easily explored is crucial for patients without feasible cephalic vein or for those who need port reimplantation because of disease relapse. In this study, we tried to analyze the safety and feasibility of catheter implantation via the deltoid branch of the thoracoacromial vein.From March 2012 to November 2013, 802 consecutive oncology patients who had received intravenous port implantation via the superior vena cava were enrolled in this study. The functional results and complications of different entry vessels were compared.The majority of patients (93.6%) could be identified as thoracoacromial vessel. The deltoid branch of the thoracoacromial vein is located on the medial aspect of the deltopectoral groove beneath the pectoralis major muscle (85.8%) and in the deep part of the deltopectoral groove (14.2%). Due to the various calibers employed and tortuous routes followed, we utilized 3 different methods for catheter implantation, including vessel cutdown (47.4%), wire assisted (17.9%), and modified puncture method (34.6%). The functional results and complication rate were similar to other entry vessels.The deltoid branch of the thoracoacromial vein is located in the neighborhood of the cephalic vein. The functional results of intravenous port implantation via the deltoid branch of the thoracoacromial vein are similar to other entry vessels. It is a safe alternative entry vessel for intravenous port implantation.
入路血管对于静脉输液港植入至关重要。对于没有可行头静脉的患者或因疾病复发需要重新植入输液港的患者而言，一条易于探寻的安全备用入路血管至关重要。在本研究中，我们试图分析经胸肩峰静脉三角肌支进行导管植入的安全性和可行性。
2012年3月至2013年11月，连续纳入802例经上腔静脉植入静脉输液港的肿瘤患者。比较不同入路血管的功能结果和并发症情况。
大多数患者（93.6%）可确定为胸肩峰血管。胸肩峰静脉三角肌支位于胸大肌下方三角胸肌沟的内侧（85.8%）以及三角胸肌沟的深部（14.2%）。由于所使用的管径不同以及走行迂曲，我们采用了3种不同的导管植入方法，包括血管切开法（47.4%）、导丝辅助法（17.9%）和改良穿刺法（34.6%）。其功能结果和并发症发生率与其他入路血管相似。
胸肩峰静脉三角肌支位于头静脉附近。经胸肩峰静脉三角肌支植入静脉输液港的功能结果与其他入路血管相似。它是静脉输液港植入的一种安全备用入路血管。
