The clinical application of A new DSA-Guided axillary vein puncture technique for venous infusion port

To explore the feasibility of a new guidance method for axillary vein puncture, a totally implantable venous access port (TIVAP) was implanted via axillary vein puncture guided by a 30-degree contralateral oblique view of digital subtraction angiography (DSA). This retrospective study reviewed clinical data of 275 patients who underwent TIVAP implantation at the Oncology Treatment Center of Tianjin Union Medical Center (February 2022 - November 2024). The success rate of puncture, puncture-related complications, and short-term follow-up outcomes in patients undergoing TIVAP implantation via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA were analyzed. 57 patients were implanted with TIVAP via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA. The right axillary vein approach was used in 53 cases (93.0%), and the left axillary vein approach was used in 4 cases (7.0%), among which 2 cases were switched to the left side due to venous anomalies on the right side. The puncture success rate was 100%. Two cases (3.5%) had accidental puncture of the subclavian artery, but no local hematoma occurred after compression. There were no puncture-related complications such as pneumothorax, air embolism, arrhythmia, or nerve damage. All patients completed a 1-month follow-up, during which no delayed hematoma, venous thrombosis, or port infection was detected. TIVAP implantation via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA demonstrated high technical success and acceptable short-term safety and serves as a feasible alternative in selected patients.