Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Geriatr Gerontol Int. 2019 Mar;19(3):218-221. doi: 10.1111/ggi.13611. Epub 2019 Feb 5.
Ultrasound guidance has become the routine method for catheterization, dramatically reducing failure and complication rates for totally implantable venous access devices (TIVAD) placement. The aim of the present study was to report the safety and efficacy of ultrasound-guided right innominate vein TIVAD placement in older patients.
Between September 2015 and September 2017, 55 older patients underwent right innominate vein TIVAD placement under ultrasound guidance. Intraoperative fluoroscopy was always carried out. The technical success rate and complications were recorded and retrospectively analyzed.
The technical success rate was 100%. The success rate of the first puncture was 96.36% (53/55). The mean operation time was 28 ± 7 min (range 23-39 min), and the mean length of catheter introduction was 19.24 ± 2.65 cm (range 17-21 cm). The overall incidence of complications was 7.27% (4/55), including one arterial puncture with self-limiting hematoma, two cases of catheter-related infection and one case of fibrin sheath. No catheter malposition or catheter fracture was observed. At the time of this study, three TIVAD were pulled out unexpectedly, and 32 TIVAD are still in functional use.
Ultrasound-guided puncture of the right innominate vein is safe and reliable to implant TIVAD, which can provide new options for older patients. Geriatr Gerontol Int 2019; 19: 218-221.
超声引导已成为导管插入术的常规方法，显著降低了完全植入式静脉通路装置（TIVAD）放置的失败率和并发症发生率。本研究旨在报告超声引导下高龄患者右无名静脉 TIVAD 置入的安全性和有效性。
2015 年 9 月至 2017 年 9 月，55 例高龄患者在超声引导下行右无名静脉 TIVAD 置入术。术中始终进行透视检查。记录并回顾性分析手术的技术成功率和并发症。
技术成功率为 100%。首次穿刺成功率为 96.36%（53/55）。平均手术时间为 28±7min（范围 23-39min），平均导管导入长度为 19.24±2.65cm（范围 17-21cm）。总的并发症发生率为 7.27%（4/55），包括 1 例动脉穿刺致自限性血肿，2 例导管相关性感染和 1 例纤维鞘。未观察到导管错位或导管断裂。在本研究时，有 3 个 TIVAD 意外拔出，32 个 TIVAD 仍在正常使用。
超声引导下右无名静脉穿刺植入 TIVAD 安全可靠，可为高龄患者提供新的选择。老年医学与老年健康杂志 2019; 19: 218-221。
