{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T21:29:39Z","timestamp":1785792579354,"version":"3.56.0"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T00:00:00Z","timestamp":1619222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG5G013"],"award-info":[{"award-number":["CMRPG5G013"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p &lt; 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.<\/jats:p>","DOI":"10.3390\/jpm11050344","type":"journal-article","created":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T21:49:20Z","timestamp":1619300960000},"page":"344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long-Term Results of a Standard Algorithm for Intravenous Port Implantation"],"prefix":"10.3390","volume":"11","author":[{"given":"Ching-Feng","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan"},{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui-Ying","family":"Fu","sequence":"additional","affiliation":[{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"},{"name":"Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou 333423, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Tsung","family":"Wen","sequence":"additional","affiliation":[{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"},{"name":"Thoracic and Cardiovascular Surgery Division, Department of Surgery, New Taipei Municipal Tu-Cheng Hospital, New Taipei City 236017, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Hung","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan"},{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Ju","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan"},{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Hen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan"},{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Ping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan"},{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3838-6717","authenticated-orcid":false,"given":"Ching-Yang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan"},{"name":"Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/j.jvir.2013.12.571","article-title":"A Single-Incision Technique for Placement of Implantable Venous Access Ports via the Axillary Vein","volume":"25","author":"Seo","year":"2014","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1177\/000313481808400629","article-title":"A Prospective, Comparative Evaluation on Totally Implantable Venous Access Devices by External Jugular Vein versus Cephalic Vein Cutdown","volume":"84","author":"Iorio","year":"2018","journal-title":"Am. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.ejrad.2009.12.010","article-title":"Jugular versus subclavian totally implantable access ports: Catheter position, complications and intrainterventional pain perception","volume":"79","author":"Plumhans","year":"2011","journal-title":"Eur. J. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.1007\/s00268-011-1200-x","article-title":"Catheter Fracture of Intravenous Ports and its Management","volume":"35","author":"Wu","year":"2011","journal-title":"World J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ejvs.2012.03.010","article-title":"Risk Factors and Possible Mechanisms of Intravenous Port Catheter Migration","volume":"44","author":"Wu","year":"2012","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1097\/SLA.0b013e31824c1c21","article-title":"Risk factors and possible mechanisms of superior vena cava intravenous port malfunction","volume":"255","author":"Wu","year":"2012","journal-title":"Ann. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s00595-013-0610-9","article-title":"A single-center study of vascular access sites for intravenous ports","volume":"44","author":"Wu","year":"2014","journal-title":"Surg. Today"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e728","DOI":"10.1097\/MD.0000000000000728","article-title":"Deltoid branch of thoracoacromial vein: A safe alternative entry vessel for intravenous port implan-tation","volume":"94","author":"Su","year":"2015","journal-title":"Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1177\/1129729818781270","article-title":"Clinical outcomes of totally implantable venous access port placement via the axillary vein in patients with head and neck malignancy","volume":"20","author":"Hong","year":"2018","journal-title":"J. Vasc. Access"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1177\/1129729818765062","article-title":"Effect of catheter diameter on left innominate vein in breast cancer patients after totally im-plantable venous access port placement","volume":"19","author":"Song","year":"2018","journal-title":"J. Vasc. Access"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sun, X., Bai, X., Shen, J., Yu, Z., Zhuang, Z., and Jin, Y. (2019). Comparison between ultrasound-guided TIVAD via the right innominate vein and the right inter-nal jugular vein approach. BMC Surg., 19.","DOI":"10.1186\/s12893-019-0651-0"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1245\/s10434-008-0224-4","article-title":"Port-A-Cath Implantation Using Percutaneous Puncture Without Guidance","volume":"16","author":"Ku","year":"2008","journal-title":"Ann. Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"422","DOI":"10.5606\/tgkdc.dergisi.2018.15299","article-title":"Experience in totally implantable venous port catheter: Analysis of 3000 patients in 12 years","volume":"26","year":"2018","journal-title":"Turk. J. Thorac. Cardiovasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"499","DOI":"10.5606\/tgkdc.dergisi.2019.17972","article-title":"Complications and management strategies of totally implantable venous access port inser-tion through percutaneous subclavian vein","volume":"27","year":"2019","journal-title":"Turk. J. Thorac. Cardiovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1245\/s10434-010-1005-4","article-title":"Increased use of percutaneous technique for totally implantable venous access de-vices. Is it real progress? A 27-year comprehensive review on early complications","volume":"17","author":"Pulvirenti","year":"2010","journal-title":"Ann Surg Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e1381","DOI":"10.1097\/MD.0000000000001381","article-title":"The Treatment Results of a Standard Algorithm for Choosing the Best Entry Vessel for Intrave-nous Port Implantation","volume":"94","author":"Wei","year":"2015","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"214","DOI":"10.4097\/kjae.2010.59.3.214","article-title":"Catastrophic hemothorax on the contralateral side of the insertion of an implantable subcla-vian venous access device and the ipsilateral side of the removal of the infected port-A case report","volume":"59","author":"Lee","year":"2010","journal-title":"Korean J. Anesthesiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"904","DOI":"10.12659\/AJCR.895486","article-title":"A Life-Threatening Mediastinal Hematoma after Central Venous Port System Implanta-tion","volume":"16","author":"Sarach","year":"2015","journal-title":"Am. J. Case Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/0002-9610(84)90340-4","article-title":"The \u201cpinch-off sign\u201d: A warning of impending problems with permanent subclavian catheters","volume":"148","author":"Aitken","year":"1984","journal-title":"Am. J. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.avsg.2019.02.030","article-title":"SVC port catheter tip confirmation: Quantified formula for intravascular catheter length versus anatomic landmark reference","volume":"60","author":"Wu","year":"2019","journal-title":"Ann. Vasc Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e2199","DOI":"10.1097\/MD.0000000000002199","article-title":"Dose Intraoperative Fluoroscopy Precisely Predict Catheter Tip Location via Superior Vena Cava Route?","volume":"94","author":"Wu","year":"2015","journal-title":"Medicine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.21873\/invivo.11707","article-title":"Cephalic Vein Cut-down for Totally Implantable Central Venous Access Devices With Preoperative Ultrasonography by Surgical Residents","volume":"33","author":"Hashimoto","year":"2019","journal-title":"Vivo"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"v152","DOI":"10.1093\/annonc\/mdv296","article-title":"Central venous access in oncology: ESMO Clinical Practice Guidelines","volume":"26","author":"Furlanetto","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1007\/s10434-000-0496-9","article-title":"A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients","volume":"7","author":"Povoski","year":"2000","journal-title":"Ann. Surg. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1002\/jbm.b.33911","article-title":"Initial experiences with a new design for a preattached intravenous port device","volume":"106","author":"Wu","year":"2018","journal-title":"J. Biomed. Mater. Res. Part. B Appl. Biomater."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1007\/s00595-014-0893-5","article-title":"Analysis of chest X-ray plain film images of intravenous ports inserted via the superior vena cava","volume":"44","author":"Fu","year":"2014","journal-title":"Surg. Today"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wu, C.Y., Cheng, C.H., Fu, J.Y., Chu, Y., Wu, C.F., Chiu, C.H., Ko, P.-J., and Liu, Y.-H. (2018). Recommended irrigation volume for an intravenous port: Ex vivo simulation study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201785"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e17757","DOI":"10.1097\/MD.0000000000017757","article-title":"Current port maintenance strategies are insufficient: View based on actual presentations of implanted ports","volume":"98","author":"Chou","year":"2019","journal-title":"Medicine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s11239-017-1569-y","article-title":"Reducing catheter-related thrombosis using a risk reduction tool centered on catheter to vessel ratio","volume":"44","author":"Spencer","year":"2017","journal-title":"J. Thromb. Thrombolysis"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/5\/344\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:52:24Z","timestamp":1760161944000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/5\/344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,24]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["jpm11050344"],"URL":"https:\/\/doi.org\/10.3390\/jpm11050344","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,24]]}}}