Scholarlink

Background <p>Totally implantable venous access devices (TIVADs) are essential for the long-term management of oncology patients. Although access via the right internal jugular vein is usually preferred due to its favorable anatomy, left-sided access becomes necessary in certain cases (anatomical variations, previous surgeries, or thromboses) by employing the supraclavicular Yoffa technique.</p> Methods <p>We describe a standardized and optimized approach using the Yoffa technique for left-sided TIVAD placement. Our protocol details patient positioning, venous puncture, guidewire insertion, subcutaneous tunneling, and port chamber implantation. This retrospective study included 719 patients, of which 216 underwent the left-sided approach.</p> Results <p>The left-sided technique was successfully performed with low rates of early complications (pneumothorax 0.42%, hematoma 1.25%, arterial puncture 0.42%) and late complications (catheter-associated thrombosis 0.42%, port pocket infection 1.39%, catheter migration 0.14%) comparable to those obtained with the right-sided approach (503 patients, 69.95%). The main indications for the left-sided approach included right-sided obstruction, previous surgical or radiation history, and failed right-sided access (Rupp SM and Apfelbaum JL Anesth Analg 85(4):741–746) (1997); McGee DC and Gould MK. N Engl J Med 348(12):1123–1133 (2003);&#xa0;Souadka et al PLoS ONE 15(11):e0242727&#xa0;(2020).</p> Conclusion <p>The left-sided Yoffa technique offers a safe and effective alternative for TIVAD placement when right-sided access is contraindicated or difficult. Its supraclavicular approach minimizes the risk of complications (pneumothorax, arterial puncture) and ensures an optimal catheter trajectory toward the superior vena cava.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Left-sided yoffa technique: a safe and optimized approach for totally implantable venous access device (TIVAD) placement

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月10日

查看全文
  • Yassine El Bouazizi,
  • Amine El Bouazizi,
  • Zakaria El Mouatassim,
  • Oumayma Lahnaoui,
  • Mohammed Anass Majbar,
  • Abdelilah Souadka,
  • Amine Souadka

摘要

Background

Totally implantable venous access devices (TIVADs) are essential for the long-term management of oncology patients. Although access via the right internal jugular vein is usually preferred due to its favorable anatomy, left-sided access becomes necessary in certain cases (anatomical variations, previous surgeries, or thromboses) by employing the supraclavicular Yoffa technique.

Methods

We describe a standardized and optimized approach using the Yoffa technique for left-sided TIVAD placement. Our protocol details patient positioning, venous puncture, guidewire insertion, subcutaneous tunneling, and port chamber implantation. This retrospective study included 719 patients, of which 216 underwent the left-sided approach.

Results

The left-sided technique was successfully performed with low rates of early complications (pneumothorax 0.42%, hematoma 1.25%, arterial puncture 0.42%) and late complications (catheter-associated thrombosis 0.42%, port pocket infection 1.39%, catheter migration 0.14%) comparable to those obtained with the right-sided approach (503 patients, 69.95%). The main indications for the left-sided approach included right-sided obstruction, previous surgical or radiation history, and failed right-sided access (Rupp SM and Apfelbaum JL Anesth Analg 85(4):741–746) (1997); McGee DC and Gould MK. N Engl J Med 348(12):1123–1133 (2003); Souadka et al PLoS ONE 15(11):e0242727 (2020).

Conclusion

The left-sided Yoffa technique offers a safe and effective alternative for TIVAD placement when right-sided access is contraindicated or difficult. Its supraclavicular approach minimizes the risk of complications (pneumothorax, arterial puncture) and ensures an optimal catheter trajectory toward the superior vena cava.