{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T06:38:34Z","timestamp":1793255914962,"version":"4.5.0"},"reference-count":55,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>The insertion of totally implantable venous access devices (ports) is a procedure widely used in clinical practice. Ports are generally used in cancer patients undergoing chemotherapy and in patients who require long-term, infrequent access (less than once a week). Over the past four decades, ports have been inserted primarily by direct cannulation of the deep veins of the supra\/infra-clavicular area, with subcutaneous placement of the reservoir over the pectoralis major muscle (so-called \u201cthoracic port\u201d or \u201cchest-port\u201d). This paper describes an insertion bundle\u2014developed by GAVeCeLT, the Italian Group of Long-Term Venous Access Devices, and nicknamed \u201cSIC-Port\u201d (Safe Insertion of Chest-Port)\u2014which consists of few evidence-based strategies aiming to further minimize all immediate, early, or late complications potentially associated with chest-port insertion. The SIC-Port bundle is currently adopted by all training courses on chest-port insertion held by GAVeCeLT. It includes eight steps: (1) systematic ultrasound evaluation of the supra\/infra-clavicular veins according to the Rapid Central Venous Assessment (RaCeVA) protocol, thus choosing the most appropriate vein, in terms of caliber, site, depth, safety of venipuncture, and ease of tunneling; (2) appropriate hand hygiene, proper skin antisepsis, and maximal barrier precautions; (3) ultrasound-guided cannulation of the best available vein, with preference for the axillary vein (if adequate), so to avoid tunneling above the clavicle; (4) ultrasound control of the pleura, to exclude pneumothorax; (5) ultrasound-guided tip navigation; (6) intra-procedural assessment of tip location by intracavitary ECG and\/or trans-thoracic echocardiography with bubble test; (7) appropriate creation of the subcutaneous pocket over the muscle; (8) appropriate closure of the subcutaneous pocket.<\/jats:p>","DOI":"10.1177\/11297298251375833","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T04:58:32Z","timestamp":1763009912000},"page":"877-884","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["A GAVeCeLT bundle for chest-port insertion: The SIC-Port protocol"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6892-474X","authenticated-orcid":false,"given":"Fabrizio","family":"Brescia","sequence":"first","affiliation":[{"name":"Unit of Anesthesia and Intensive Care Medicine, Vascular Access Team, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-1311","authenticated-orcid":false,"given":"Maria Giuseppina","family":"Annetta","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9926-2128","authenticated-orcid":false,"given":"Fulvio","family":"Pinelli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Careggi University Hospital, Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2225-7654","authenticated-orcid":false,"given":"Mauro","family":"Pittiruti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fondazione Policlinico Universitario \u201cA. 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