Research article
Combined approach for port-a-cath implantation -a dependable alternative
Authors:
D. Guruprasad Rai,
Kasturba Medical College, Manipal Academy of Higher Education, Manipal, IN
About D. Guruprasad
Associate Professor
Vijaya Kumara ,
Kasturba Medical college, Manipal Academy of Higher Education, Manipal, IN
About Vijaya
Associate Professor
Arvind kumar Bishnoi,
Manipal Academy of Higher Education, Manipal, IN
About Arvind kumar
Professor, Kasturba Medical College
Ganesh S. Kamath,
Manipal Academy of Higher Education, Manipal, IN
About Ganesh S.
Professor, Kasturba Medical College
Rajkamal Vishnu,
Manipal Academy of Higher Education, Manipal., IN
About Rajkamal
Assistant Professor, Kasturba Medical College
Harshil Joshi,
Manipal Academy of Higher Education, Manipal
About Harshil
Assistant Professor, Kasturba Medical Collage
Lokavendra Singh Budania,
Manipal Academy of Higher Education, Manipal, IN
About Lokavendra Singh
Associate Professor, Kasturba Medical College
Yogesh K. Gaude
Manipal Academy of Higher Education, Manipal, IN
About Yogesh K.
Associate Professor, Kasturba Medical College
Abstract
Background: Port-a-Cath are routinely warranted as a universal venous access for chemotherapy, due to their operational ease, comparatively less complications and relative ease of maintenance. Catheter implantation can be done either by surgical approach by vein cut-down technique or ultrasound-guided percutaneous technique or by landmark technique using fluoroscopy .Here we present our data on our novel technique.
Methods: A descriptive cross-sectional study of 92 consecutive patients who underwent Port-a-Cath implantation for adjuvant therapy, from August 2017 through to July 2019 was done. The procedure was carried out in the minor operation theatre under local anaesthesia with anaesthetist doing a transthoracic echocardiography and surgeon doing a cephalic vein cut down under echocardiography guidance, as a day care procedure. This allowed the catheter to reach the superior vena cava smoothly thus avoiding inadvertent cannulation of the internal jugular vein.
Results: Four (4.34%) of t92 patients required additional sedation. No patients required to be re-explored in lieu of erroneous placement of the catheter. In all patients the catheter was placed properly in the superior vena cava- right atrial junction. Late complications amounted to 8.69% of the study group, this included flip over, puncture site infection and catheter blockage. All patients were followed-up for a period of 1 to 6 months.
Conclusions: We advocate a combined approach of echocardiography guided Port-a-Cath insertion through cephalic vein cut down as a simple, safe, with satisfactory success rate. It offers a suitable alternative to the other invasive procedures performed under image guidance and avoids radiation exposure and malposition.
How to Cite:
Rai, D.G., Kumara, V., Bishnoi, A. kumar ., Kamath, G.S., Vishnu, R., Joshi, H., Budania, L.S. and Gaude, Y.K., 2020. Combined approach for port-a-cath implantation -a dependable alternative. Sri Lankan Journal of Anaesthesiology, 28(2), pp.108–113. DOI: http://doi.org/10.4038/slja.v28i2.8570
Published on
27 Jun 2020.
Peer Reviewed
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