Abstract
Background: The external jugular vein (EJV) approach for totally implantable venous access devices (TIVADs) is safe. However, the success rate is unsatisfactory because of the difficulty in catheterization due to the acute angle between the EJV and the subclavian vein (SCV). A novel “shrug technique” to overcome this difficulty was developed, and its efficacy was assessed in a consecutive case series. Methods: TIVAD placement was performed via the EJV cut-down approach. “Shrug technique,” a simple way to straighten the EJV–SVC angle by shrugging the patient's shoulder, was applied to facilitate the passage of the guidewire and sheath-introducer when there was acute angulation between the EJV and SCV. Results: A total of 254 patients underwent TIVAD implantation by the EJV cut-down approach. The “shrug technique” was applied in 51 cases (20%), and catheterization was successful in all cases. Thus, TIVAD implantation was successfully completed in all 254 cases (100%) in a single operative setting. The median operating time was 38 [IQR 30–45] min. Eleven complications (4%) were observed, but none of them were EJV-specific. Conclusion: The “shrug technique” is simple but very useful to achieve a higher success rate and safer insertion of TIVADs from the EJV. J. Surg. Oncol. 2017;115:291–295.
| Original language | English |
|---|---|
| Pages (from-to) | 291-295 |
| Number of pages | 5 |
| Journal | Journal of Surgical Oncology |
| Volume | 115 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2017 |
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Keywords
- cut-down
- external jugular vein
- totally implantable venous access device
ASJC Scopus subject areas
- Surgery
- Oncology
Cite this
A novel “shrug technique” for totally implantable venous access devices via the external jugular vein : A consecutive series of 254 patients. / Kagawa, Tetsuya; Ueyama, Satoshi; Kobayashi, Tatsunori; Okabayashi, Hiroki; Kuroda, Shinji; Fujiwara, Toshiyoshi.
In: Journal of Surgical Oncology, Vol. 115, No. 3, 01.03.2017, p. 291-295.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A novel “shrug technique” for totally implantable venous access devices via the external jugular vein
T2 - A consecutive series of 254 patients
AU - Kagawa, Tetsuya
AU - Ueyama, Satoshi
AU - Kobayashi, Tatsunori
AU - Okabayashi, Hiroki
AU - Kuroda, Shinji
AU - Fujiwara, Toshiyoshi
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: The external jugular vein (EJV) approach for totally implantable venous access devices (TIVADs) is safe. However, the success rate is unsatisfactory because of the difficulty in catheterization due to the acute angle between the EJV and the subclavian vein (SCV). A novel “shrug technique” to overcome this difficulty was developed, and its efficacy was assessed in a consecutive case series. Methods: TIVAD placement was performed via the EJV cut-down approach. “Shrug technique,” a simple way to straighten the EJV–SVC angle by shrugging the patient's shoulder, was applied to facilitate the passage of the guidewire and sheath-introducer when there was acute angulation between the EJV and SCV. Results: A total of 254 patients underwent TIVAD implantation by the EJV cut-down approach. The “shrug technique” was applied in 51 cases (20%), and catheterization was successful in all cases. Thus, TIVAD implantation was successfully completed in all 254 cases (100%) in a single operative setting. The median operating time was 38 [IQR 30–45] min. Eleven complications (4%) were observed, but none of them were EJV-specific. Conclusion: The “shrug technique” is simple but very useful to achieve a higher success rate and safer insertion of TIVADs from the EJV. J. Surg. Oncol. 2017;115:291–295.
AB - Background: The external jugular vein (EJV) approach for totally implantable venous access devices (TIVADs) is safe. However, the success rate is unsatisfactory because of the difficulty in catheterization due to the acute angle between the EJV and the subclavian vein (SCV). A novel “shrug technique” to overcome this difficulty was developed, and its efficacy was assessed in a consecutive case series. Methods: TIVAD placement was performed via the EJV cut-down approach. “Shrug technique,” a simple way to straighten the EJV–SVC angle by shrugging the patient's shoulder, was applied to facilitate the passage of the guidewire and sheath-introducer when there was acute angulation between the EJV and SCV. Results: A total of 254 patients underwent TIVAD implantation by the EJV cut-down approach. The “shrug technique” was applied in 51 cases (20%), and catheterization was successful in all cases. Thus, TIVAD implantation was successfully completed in all 254 cases (100%) in a single operative setting. The median operating time was 38 [IQR 30–45] min. Eleven complications (4%) were observed, but none of them were EJV-specific. Conclusion: The “shrug technique” is simple but very useful to achieve a higher success rate and safer insertion of TIVADs from the EJV. J. Surg. Oncol. 2017;115:291–295.
KW - cut-down
KW - external jugular vein
KW - totally implantable venous access device
UR - http://www.scopus.com/inward/record.url?scp=84996525953&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84996525953&partnerID=8YFLogxK
U2 - 10.1002/jso.24504
DO - 10.1002/jso.24504
M3 - Article
C2 - 27813159
AN - SCOPUS:84996525953
VL - 115
SP - 291
EP - 295
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 3
ER -