Totally Implantable Central Venous Port Catheters: Radiation Exposure as a Function of Puncture Site and Operator Experience

完全植入式中心静脉输液港导管:穿刺部位和操作者经验与辐射暴露的关系

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Abstract

BACKGROUND: Totally implantable central venous port systems provide a safe and effective, long-term means of access for administration of hyperosmolar, local irritant medication, such as chemotherapy, antibiotics and parenteral nutrition. AIM: To evaluate the combination of access site and level of experience on fluoroscopy times (FT) and dose area products (DAP) during implantation of port catheters in a large patient population. MATERIALS AND METHODS: A total of 1,870 patients (992 women, 878 men; age: 61±13.14 years) were reviewed investigating two groups of junior (≤50 implantations) and senior (>50) radiologists. RESULTS: Senior radiologists required less FT/DAP (0.24 s/57.3 μGy m(2) versus 0.43 s/68.2 μGy m(2), respectively; p<0.001). Right jugular vein access required the least FT/DAP (0.25 s/56.15 μGy m(2)) and right-sided implantation lower FT/DAP (right: 0.26 s/56.4 μGy m(2), left: 0.40 s/85.10 μGy m(2), p<0.001). CONCLUSION: Due to DAP/FT reductions, the right jugular vein seems to be the most favorable implantation side for port systems. For further dose reduction, residents should be well-trained.

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