Evaluation of the catheter tip position among children with totally implantable port during 2015 in Dr. Sheikh Children’s hospital

Reza Shojaeian, mohammad mahdi khazravi



Background: Totally implantable port insertion is a common procedure in pediatrics surgery and the main concern is the tip catheter position, which is directly related to its complications, failure and durability. The best position is in SVC/RA junction which is compatible with carina or T5-T6 vertebral level in X-ray.

In our center we routinely use surface anatomy to estimate the adequate length for the tip to reach SVC/RA junction. In this study we compared the precision and accuracy of this method by post-operative X-ray study.

Materials and methods: as a retrospective study we evaluated the accuracy of surface anatomical land marks to estimate the catheter tip position, considering the carina or vertebra in X-rays which represents the SVC/RA junction. 48 patients were included and their records were reviewed in Dr. Sheikh Children’s hospital (Mashhad).

Results: Considering the carina as the best radiographic land mark, we had accurate tip position just  in 29.2%,over insertion in 45.8% and under inserted catheter tip in 10.4%.Considering the vertebral bodies as radiographic land mark,50% were over inserted ,35.4% accurate and 14.6% under inserted.

Conclusion: Regarding our high rate of catheter tip mal-position arising from considering surface anatomy alone, we suggest not only to rely on surface anatomy but use imaging modalities such as portable X-ray, fluoroscopy or ultra-Sonography within the operation room while inserting implantable port devices.


Keywords: pediatrics; implantable catheter; superior vena cava; access port; chest x ray

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DOI: https://doi.org/10.22037/irjps.v4i2.21466


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