Safety and Efficacy of Standardized Internal Jugular Vein Totally Implantable Venous Access Ports: Focus on Complication Profile and Risk Factors

Background Totally implantable venous access ports (TIVAPs) are essential for chemotherapy delivery but carry complication risks potentially mitigated by standardized procedures. This study assessed the safety and efficacy of ultrasound-guided internal jugular vein (IJV) TIVAP implantation under a standardized protocol in cancer patients, with a specific focus on characterizing complications and identifying risk factors. Methods A retrospective analysis included 175 cancer patients who underwent right IJV TIVAP implantation (B. Braun Celsite ST305P, 6.5 F) between September 2020 and March 2024. Standardized procedures mandated ultrasound-guided puncture, intraoperative fluoroscopic tip positioning (target: cavoatrial junction), and postoperative chest X-ray. Procedural success, operative time, patient demographics, comorbidities, and complications (early: ≤30 days; late: >30 days) were recorded. Multivariable Cox regression identified complication risk factors. Results procedural success was 100% (175/175). The mean operative time was 40 ± 12 minutes. Crucially, no early complications (0/175) occurred. Late complications developed in 14 patients (8.0%, incidence: 0.05/1000 catheter days). All late complications were skin ulcers around the port/catheter with device exposure. Multivariable analysis revealed that concurrent diabetes mellitus and hypertension (DM + HTN) was the only significant independent predictor of complications (Hazard Ratio (HR) = 12.223, 95% Confidence Interval (CI): 1.168-127.929, P = 0.037) compared to patients without these comorbidities. Age, sex, tumor type, and BMI were not significant risk factors. Conclusions Ultrasound-guided IJV TIVAP implantation under the described standardized protocol is safe (no early complications) and effective (100% success). The predominant late complication was skin ulceration. The concurrent presence of diabetes and hypertension represents a strong independent risk factor for TIVAP-related complications, emphasizing the critical need for comprehensive preoperative risk assessment and optimization of metabolic health in these patients.