Objective
Intracavitary electrocardiography (IC-ECG) has been extensively used for locating
the catheter tip of the central venous access devices (CVADs) with favorable safety
and accuracy. We aimed to evaluate the efficacy, safety, and cost-effectiveness of
IC-ECG-guided catheter tip placement for totally implantable venous access port (TIVAP)
by comparing with the standard fluoroscopy method.
Methods
A total of 231 patients who underwent TIVAP implantation from September 2019 to April
2021 were enrolled in the retrospective study. Fluoroscopy and IC-ECG were conducted
intraoperatively to confirm the position of catheter tips. Demographic characteristics,
surgical data, the catheter tip position, complication rate, and incidence, cost of
procedures, and indwelling time were compared between the two groups. Univariate and
multivariate analyses were used to identify the risk factors of TIVAP-related complications.
Results
There was no significance between the fluoroscopy group and the IC-ECG group in terms
of the rate of ideal position (P = 0.733). Nine patients (3.9%) developed TIVAP-related complications. Complication
rates and incidence were similar in the fluoroscopy group and the IC-ECG group (3.1%
and 0.114/1000 catheter days vs. 4.4% and 0.105/1000 catheter days). The Kaplan-Meier
curve showed that there was no significant difference in indwelling time between the
2 groups (Log Rank P = 0.634). Binary logistic regression analysis showed that body mass index (BMI) was
an independent risk factor for TIVAP-related complications (OR = 1.334, 95%CI: 1.139
- 1.563, P < 0.001). The IC-ECG group was less costly than the fluoroscopy group (¥9928 ± 362
vs. ¥11762 ± 431, P < 0.001).
Conclusions
IC-ECG-guided catheter tip placement for TIVAP is feasible, safe, and cost-effective,
with high accuracy, low risk of complications, and lower cost. It may be considered
as an alternative to the standard fluoroscopy method for catheter tip placement of
TIVAP.
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Article Info
Publication History
Published online: December 18, 2021
Accepted:
November 28,
2021
Received in revised form:
November 19,
2021
Received:
October 7,
2021
Footnotes
Zhan Liu and Xia Zheng contributed equally to this work.
The Authors declare no conflict of interest.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
