Routine chest X-ray is not mandatory after fluoroscopy-guided totally implantable venous access device insertion
| Autor: | Max Scheffler, Christoph D. Becker, Theodoros Thomopoulos, Christian Toso, Ilias Bagetakos, Antoine Paul Lomessy, Philippe Morel, Jeremy Meyer, Wojciech Staszewicz |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Catheterization Central Venous medicine.medical_specialty Percutaneous medicine.medical_treatment Venous cutdown Radiography Interventional Asymptomatic ddc:616.0757 Catheters Indwelling Postoperative Complications Predictive Value of Tests Risk Factors medicine Central Venous Catheters Humans Fluoroscopy Aged Retrospective Studies Aged 80 and over Hemothorax medicine.diagnostic_test ddc:617 business.industry Patient Selection Pneumothorax Venous Cutdown General Medicine medicine.disease 3. Good health Surgery Venous access Catheter Female Radiography Thoracic Radiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Annals of Vascular Surgery, Vol. 28, No 2 (2014) pp. 345-50 Annals of Vascular Surgery |
| ISSN: | 0890-5096 |
| Popis: | Background: The aim of this study is to determine whether systematic postoperative chest X ray is required after totally implantable venous access port device (TIVAD) placement under fluoroscopic control. Methods: A retrospective chart review of all consecutive patients with fluoroscopy guided TIVAD insertion from July 10 2009 to April 16 2012 was conducted at the Geneva University Hospitals (n = 927). Patients with an available postoperative chest X ray were included regardless of approach (open or percutaneous) and venous access site (subclavian cephalic jugular etc.). Exclusion criteria were incomplete data and preexisting pneumothorax or hemothorax. Results: Eight hundred ninety one patients were included. First intention venous cutdown was performed in 878 patients (98.5) with success rates of 79.4 and 88.2 when targeting the left and right cephalic veins respectively. Percutaneous access was the chosen first intention procedure for 12 patients (1.3). Eight hundred thirty six (93.8) insertions were performed only by the open approach and 53 (5.9) implantations required at least one venous puncture. Two implantations were performed using previous central venous accesses. Immediate complications associated with TIVAD placement and detected on the postoperative chest X ray consisted of 1 asymptomatic pneumothorax 1 symptomatic hemothorax and 2 malpositions of the catheter. One additional pneumothorax was discovered during the first night after TIVAD insertion in a patient who became symptomatic. Conclusions: The very low incidence of immediate complications detected by postprocedural chest X ray suggests that such a control is not mandatory as a routine method after fluoroscopy guided TIVAD insertion mainly performed by venous cutdown. X ray should be performed only in cases of clinical suspicion. © 2013 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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