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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
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Vijaya Kumara ,

Kasturba Medical college, Manipal Academy of Higher Education, Manipal, IN
About Vijaya
Associate Professor
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Arvind kumar Bishnoi,

Manipal Academy of Higher Education, Manipal, IN
About Arvind kumar
Professor, Kasturba Medical College
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Ganesh S. Kamath,

Manipal Academy of Higher Education, Manipal, IN
About Ganesh S.
Professor, Kasturba Medical College
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Rajkamal Vishnu,

Manipal Academy of Higher Education, Manipal., IN
About Rajkamal
Assistant Professor, Kasturba Medical College
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Harshil Joshi,

Manipal Academy of Higher Education, Manipal
About Harshil
Assistant Professor, Kasturba Medical Collage
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Lokavendra Singh Budania,

Manipal Academy of Higher Education, Manipal, IN
About Lokavendra Singh
Associate Professor, Kasturba Medical College
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Yogesh K. Gaude

Manipal Academy of Higher Education, Manipal, IN
About Yogesh K.
Associate Professor, Kasturba Medical College
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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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