Image-Guided TIVAP by Interventional Radiologists: A Single-Center Cohort Study Using Institutional Surgical Benchmarks

Background/Objectives: To evaluate the resource utilization, procedural costs, procedure time, and intraprocedural outcomes of interventional radiology (IR)-guided totally implantable venous access port (TIVAP) placement and contextualize these findings using institutional surgical benchmarks. Methods: We conducted a single-center study between March 2020 and March 2024 that included 93 patients requiring TIVAP placement for chemotherapy. All ports were inserted under ultrasound and fluoroscopic guidance in an angiography suite. Surgical insertions using a cephalic vein cut-down under anesthesia were used as a comparator. Data collected included number of consent forms, staffing, procedure duration, material and medication utilization, and procedural costs obtained from hospital financial records. Descriptive statistics were used to summarize outcomes. Results: IR-guided TIVAP insertion required one combined consent form and two personnel, compared with two consent forms and four personnel for the surgical workflow. The average procedural cost in the angiography suite was €168.16 versus an institutional surgical benchmark of €407.90, representing a 58.8% lower observed cost. The recorded average procedure time was 45 min for IR versus 85 min for the surgical benchmark. Material costs were comparable, except for intravenous anesthetic agents used in the operating room. No intraprocedural complications occurred among the 93 IR cases. Conclusions: IR-guided TIVAP implantation required fewer personnel and was associated with lower observed procedural costs and shorter recorded procedure times relative to institutional surgical benchmarks. The absence of a patient-level surgical comparator and long-term follow-up limits conclusions regarding comparative safety and clinical outcomes.