Radiographic External Measurement Technique for TIVAP Placement

Accuracy and Clinical Applicability of a Chest X-Ray-Based External Measurement Method for Optimal Catheter Tip Positioning in Totally Implantable Venous Access Port Placement

Totally implantable venous access ports (TIVAPs) are commonly used in patients who need long-term intravenous treatment such as chemotherapy, parenteral nutrition, or repeated blood sampling. Correct placement of the catheter tip is important to reduce the risk of complications, including arrhythmia, thrombosis, catheter dysfunction, vessel injury, and infection.

Several methods are used to determine catheter tip position during port placement, including fluoroscopy, echocardiography, and chest X-ray. However, some of these methods may require additional equipment, increase procedure time, or may not be available in all hospitals.

This study aims to evaluate a simple chest X-ray-based external measurement method to estimate the appropriate catheter length before TIVAP placement. In this method, anatomical landmarks identified on a recent chest X-ray are used to calculate the expected catheter length, which is then applied during the procedure.

The main goal of the study is to assess how accurately this method places the catheter tip in the desired anatomical position. Secondary goals include evaluating the rate of optimal tip placement, procedure-related complications, and the relationship between predicted and actual catheter tip positions.

If successful, this method may provide a practical, low-cost, and widely applicable technique to improve TIVAP placement in routine clinical practice.

Inclusion Criteria:

• Age 18 years or older
• Scheduled for elective totally implantable venous access port placement
• Available posterior-anterior chest X-ray obtained within the previous 3 months
• Ability to provide written informed consent

Exclusion Criteria:

• Known central venous stenosis or occlusion due to previous central venous catheter or port history
• Congenital heart disease
• Significant mediastinal anatomical abnormality or distortion
• Chest X-ray in which anatomical landmarks cannot be clearly identified
• Emergency port implantation
• Pregnancy (if required by local ethics policy)
• Refusal or inability to provide written informed consent