Wu S, Huang J, Jiang Z, et al. Internal jugular vein versus subclavian vein as the percutaneous insertion site for totally implantable venous access devices: a meta-analysis of comparative studies. BMC Cancer. 2016 Sep 22;16(1):747. Free full-text.
Results: Twelve studies including 3905 patients published between 2008 and 2015, were included. Our meta-analysis showed that incidences of TIVAD-related infections (odds ratio [OR] 0.71, 95 % confidence interval [CI] 0.48-1.04, P = 0.081) and catheter-related thrombotic complications (OR 0.76, 95 % CI 0.38-1.51, P = 0.433) were not significantly different between the two groups. However, compared with SCV, IJV was associated with reduced risks of total major mechanical complications (OR 0.38, 95 % CI 0.24-0.61, P < 0.001). More specifically, catheter dislocation (OR 0.43, 95 % CI 0.22-0.84, P = 0.013) and malfunction (OR 0.42, 95 % CI 0.28-0.62, P < 0.001) were more prevalent in the SCV than in the IJV group; however, the risk of catheter fracture (OR 0.47, 95 % CI 0.21-1.05, P = 0.065) were not significantly different between the two groups. Sensitivity analyses using fixed-effects models showed a decreased risk of catheter fracture in the IJV group.
Conclusion: The IJV seems to be a safer alternative to the SCV with lower risks of total major mechanical complications, catheter dislocation, and malfunction. However, a large-scale and well-designed RCT comparing the complications of each access site is warranted before the IJV site can be unequivocally recommended as a first choice for percutaneous implantation of a TIVAD.
Nagasawa Y, Shimizu T, Sonoda H, et al. A comparison of outcomes and complications of totally implantable access port through the internal jugular vein versus the subclavian vein. Int Surg. 2014 Mar-Apr;99(2):182-8. Free full-text.
Aribaş BK, Arda K, Aribaş O, et al. Comparison of subcutaneous central venous port via jugular and subclavian access in 347 patients at a single center. Exp Ther Med. 2012 Oct;4(4):675-680. doi: 10.3892/etm.2012.649. Epub 2012 Jul 30.
Plumhans C, Mahnken AH, Ocklenburg C, et al. Jugular versus subclavian totally implantable access ports: catheter position, complications and intrainterventional pain perception. Eur J Radiol. 2011 Sep;79(3):338-42. Full-text for Emory users.