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Innominate vein stenosis in breast cancer patients after totally implantable venous access port placement

Authors
 Myung Gyu Song  ;  Tae-Seok Seo  ;  Eun Young Kang  ;  Hwan Seok Yong  ;  Jae Hong Seo  ;  Yoon Young Choi 
Citation
 JOURNAL OF VASCULAR ACCESS, Vol.16(4) : 315-320, 2015 
Journal Title
JOURNAL OF VASCULAR ACCESS
ISSN
 1129-7298 
Issue Date
2015
MeSH
Administration, Intravenous ; Adult ; Antineoplastic Agents/administration & dosage* ; Brachiocephalic Veins*/diagnostic imaging ; Breast Neoplasms/drug therapy* ; Catheter Obstruction/etiology* ; Catheterization, Central Venous/adverse effects* ; Catheterization, Central Venous/instrumentation* ; Catheters, Indwelling/adverse effects* ; Central Venous Catheters/adverse effects* ; Chi-Square Distribution ; Constriction, Pathologic ; Equipment Design ; Female ; Humans ; Incidence ; Jugular Veins* ; Kaplan-Meier Estimate ; Medical Records ; Middle Aged ; Phlebography/methods ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed
Keywords
Central venous access ; Stenosis ; Vein ; Venous intervention
Abstract
PURPOSE: To evaluate the risk factors for central vein stenosis after placement of the totally implantable venous access ports (TIVPs) and the clinical relevance of this condition in breast cancer patients.

MATERIALS AND METHODS: TIVPs were placed in 191 women with breast cancer via the internal jugular vein (IJV) from January 2009 to December 2012 (mean age, 51.42 years) by left-side (n = 102) and right-side (n = 89) approaches. Medical records were retrospectively reviewed. The presence of significant central vein stenosis, tip location of the catheter and retrosternal space were evaluated on chest computed tomography images. Statistical analysis was performed.

RESULTS: Central vein stenosis developed in 1 and 14 patients after placement via the right and left IJV, respectively. Differences in the cumulative incidence of central vein stenosis were statistically significant between left- and right-side approach groups (log rank test p-value: 0.009). In Cox regression analysis, the hazard ratio for central vein stenosis was 9.441 (p = 0.031) in the left-side approach. The distance between the sternum and the left innominate vein was found to be significantly and independently related to the development of central vein stenosis (p = 0.026). The hazard ratio of distances between the sternum and left innominate vein lt;16 mm was 10.133 (1.319-77.841).

CONCLUSIONS: The incidence of central vein stenosis in breast cancer patients was higher after placement of TIVPs via the left IJV. When left-side TIVP placement is required in a patient with right-side breast cancer, the possibilities of left innominate vein stenosis should be considered.
Full Text
http://web.a.ebscohost.com/ehost/detail/detail?vid=0&sid=f3ca5cfb-2753-44d1-b09f-d3f5049f5fe8%40sessionmgr4009&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=25953212&db=mdc
DOI
10.5301/jva.5000387
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157347
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