Randomized clinical trial comparing venous cutdown with the Seldinger technique for placement of implantable venous access ports
- 3 September 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 96 (10), 1129-1134
- https://doi.org/10.1002/bjs.6730
Abstract
Background The aim of this randomized controlled study was to compare the primary success rate between venous cutdown and the Seldinger technique for placement of the totally implantable venous access port (TIVAP). Methods A total of 152 patients were randomized to receive TIVAP placement by either venous cutdown or the Seldinger technique. The main endpoint was the primary success rate. Secondary endpoints included overall success rate, procedure time and perioperative complication rates. Multiple logistic regression analysis was undertaken to assess the influence of different variables on primary success. Results The primary success rate was 71 per cent for venous cutdown and 90 per cent for the Seldinger technique (P = 0·007). The mean procedure time was significantly shorter for the Seldinger technique (48·9 versus 64·8 min; P < 0·001). The overall success rate was 97·4 per cent. The rate of perioperative complications was similar for the two approaches (5 per cent), but was higher when a procedure was converted. The variables sex, body mass index, implantation side and surgeon experience had no impact on the primary success rate. Conclusion The Seldinger technique was more effective and quicker than venous cutdown, and should be regarded as the method of choice for TIVAP placement. Registration number: NCT00272623 (http://www.clinicaltrials.gov).Keywords
This publication has 24 references indexed in Scilit:
- Totally implantable venous-access ports: local problems and extravasation injuryThe Lancet Oncology, 2002
- Totally Implantable Venous Access Devices Implanted SurgicallyArchives of Surgery, 2001
- Longterm central venous access in gynecologic cancer patientsJournal of the American College of Surgeons, 2000
- Complications Related to Indwelling Caval Catheters on a Gynecologic Oncology ServiceGynecologic Oncology, 1998
- Totally implantable central venous access ports for long-term chemotherapy A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 daysAnnals Of Oncology, 1998
- Durchleuchtungsgesteuerte Implantation subkutaner Venenports: Komplikationen und LangzeitergebnisseRöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 1998
- Placement of long-term central venous catheters in outpatients: study of 134 patients over 24,596 catheter days.American Journal of Roentgenology, 1997
- Complications of indwelling venous access devices in cancer patients.Journal of Clinical Oncology, 1995
- Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access.Radiology, 1992
- Catheter Replacement of the Needle in Percutaneous Arteriography: A new techniqueActa Radiologica, 1953