SYSTEMATIC REVIEW article
Front. Surg.
Sec. Vascular Surgery
Is There a Difference in Catheter-Related Thrombosis Between Left-and Right-Sided Arm Ports and Chest Ports?
Provisionally accepted
- 1People’s Hospital of Shapingba District, Chongqing, China
- 2Army Medical Center of PLA, Chongqing, China
- 3Songshan General Hospital, Chonqing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background Totally Implantable Venous Access Ports (TIVAPs) are long-term subcutaneous venous infusion devices widely used in patients requiring prolonged venous therapy, particularly those with cancer. The choice of left-versus right-sided implantation during TIVAP implantation is a key clinical decision, as anatomical and hemodynamic differences between sides may influence the risk of catheter-related thrombosis (CRT). However, existing literature remains controversial regarding the association between implantation side and CRT incidence. This meta-analysis aims to systematically evaluate the impact of left-versus right-sided TIVAP implantation on CRT risk, providing evidence-based support for clinical prevention strategies. Methods Literature searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database to identify studies investigating the effect of left-versus right-sided TIVAP implantation on CRT incidence. The search spanned from database inception to October 2025. Two independent researchers screened literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was conducted using RevMan 5.3 software. Results A total of 21 studies involving 10,778 patients were included. Meta-analysis revealed no statistically significant difference in CRT incidence between left-and right-sided chest ports (OR = 1.28, 95%CI (0.97–1.68), P = 0.08) or arm port (OR = 1.19,95% CI (0.86–1.66), P = 0.29). Conclusions Current evidence indicates no overall difference in CRT incidence between left-and right-sided TIVAPs. However, the observed sample size-dependent association suggests that left-sided implantation may carry a slightly higher CRT risk in large cohorts. Clinicians may select the implantation side based on individual patient characteristics. However, large-sample, multi-center randomized controlled trials are needed to further validate these findings, particularly given the observed sample size-dependent differences.
Keywords: Arm port, Catheter-related thrombosis, Chest port, Meta-analysis, Totally implantable venous access ports, Venous Thrombosis
Received: 02 Nov 2025; Accepted: 29 Jan 2026.
Copyright: © 2026 Fan, Du, Guan, Zhang and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yun Fan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.