Wei Ding

and 8 more

Background and objectives: To investigate the feasibility and safety of ultrasound-guided totally implantable venous access ports (TIVAPs) via the right brachiocephalic vein (BCV) in pediatric patients. Methods: A single institutional retrospective review was performed on 35 pediatric patients with hematological malignancies who underwent TIVAPs implantation via ultrasound-guided right BCV approach from July 2018 to June 2021. Technical success rate, procedural information and TIVAP related complications were evaluated. Results: All the pediatric TIVAP devices were successfully implanted via right BCV access. Venous access was successful by first attempt in 32 children (91.42%); two cases (5.71%) required a second attempt; one patient (2.86%) required a third attempt. The mean procedural time was 44.63 ± 6.41 mins (range, 34-62 mins). No intraoperative complications occurred. The average TIVAP indwelling time was 563.51 ± 208.47 days (range, 193-1014 days) with a cumulative 19,723 catheter-days. The incidence of postoperative complications was 11.43% (4/35), corresponding to a rate of 0.20 complications per 1000 catheter-days. Two cases of local hematoma and two catheter dysfunctions occurred in three patients. No other complications such as wound dehiscence, delayed incision healing, catheter-related thrombosis (CRT), catheter malposition/fracture, surgical site infection, catheter-related bloodstream infection (CRBSI), pinch-off syndrome and drug extravasation were observed during follow-up. Conclusions: Ultrasound-guided right BCV access for TIVAPs placement in pediatric patients appears to be technically feasible, safe and effective. Further large-sample, prospective studies are warranted.