Placement of port-a-cath systems via the jugular vein: a surgical perspective

In this issue of MEMO, Erragh et al. report on a large single centre experience with placement of port-a-cath (PAC) devices via (mainly) the right internal jugular vein in cancer patients under ultrasound guidance. The PAC chamber was placed in the subclavian region and interventions were performed under local anaesthesia only. There is little doubt that this report is of clinical interest as PAC systems are of major relevance for allowing for the safe administration of cytotoxic chemotherapy, and authors describe a large case series of 3197 patients including a broad spectrum of malignant disease including 63% breast cancer patients. Complication rate was low, with no acute intervention-induced complications such as pneumothorax, bleeding or haematoma observed, thus indicating the feasibility and safety of this approach. On the downside two interventions—one in the cervical region and one in the subclavian region are required. …