Technical problems and complications following venous port system implantation: a pilot randomized study

Objective. To study the incidence of intraoperative adverse events and complications associated with different vascular access points for venous port system implantation. Material and methods. We included 158 patients divided into three groups depending on access site for port system placement (v. basilica, v. axillaris and v. jugularis interna). We assessed intraoperative adverse events, early complications within 30 days after implantation and delayed events (after 30 days). Results. Guide wire migration was significantly more common in the v. basilica and v. axillaris groups compared to the v. jugularis interna group (12, 15, and 4 instances, respectively; p=0.015). Vascular access challenges were more frequent in the v. axillaris group (p=0.021). The incidence of periprocedural arrhythmias was similar in all groups (p=0.994). There were 19 late complications, including port site infections, skin erosion at the implantation site, catheter thrombosis, pericatheter vascular thrombosis, catheter kinking with loops and extravasation. There was no significant between-group difference (p=0.935). Conclusion. Guide wire migration and difficulties in its positioning were more common in the v. basilica and v. axillaris groups. Catheterization of the v. axillaris often presents technical challenges due to deeper location. However, there is no impact on the overall complication rate. None implantation method showed superiority regarding early or late complications.