Hakkıcan AKPOLAT, Serdar DEMİRGAN, Sezen Kumaş SOLAK, Emine SÖNMEZ, Rasim Onur KARAOĞLU, Ayşin SELCAN
Turkish Journal of Anaesthesiology and Reanimation - 2026;54(2):107-116
Objective: Totally implantable venous access ports (TIVAP) provide safe and comfortable venous access for chemotherapy. This study evaluates the reliability of Lum's measurement technique for central venous catheter tip positioning and its impact on complications. Methods: Clinical and radiologic data of 297 patients undergoing TIVAP implantation were analyzed. The primary endpoint was optimal catheter tip positioning (within 2 cm above to 1 cm below the cavoatrial junction) and its effect on complications. Secondary endpoints included the impact of catheterization site and tip position relative to the carina. Results: Among 297 patients, 59.9% had catheter tips in the target zone, and 93.9% were below the carina. Target zone positioning did not significantly affect catheter occlusion or thromboembolism (P=0.066, P=0.773). However, thromboembolism (1/18; 5.6% vs. 1/279; 0.4%, P=0.009) and catheter occlusion (2/18; 11.1% vs. 3/279; 1.1%, P =0.001) were more frequent when the tip was above the carina. Patients with tips in the target zone and below the carina had similar complication rates (P =0.565, P=0.748, P=0.644). Catheterisation was performed via the internal jugular vein (IJV) or subclavian vein (SCV). Target zone positioning was more frequent with IJV catheterization (P =0.047), while catheter occlusion was higher with SCV access (P=0.024). Conclusion: Positioning the catheter tip below the carina and preferring IJV as the first-choice catheterization site may reduce complications
