Abstract
Introduction: totally implantable venous access ports (TIVAPs) offered advantage of preventing venous toxicity when administering chemotherapy drugs and low risk of toxicity. Modified techniques were introduced to improve the outcome and safety of the port implantation. In this modified technique, the prioritization were the safety and stability of catheter and port placement. Case Presentation: a female, 57 years old with stage 4 breast cancer will undergo chemotherapy. She needs to do TIVAPs because her vessel was fragile and small. The author used cephalic vein cutdown to do TIVAPs. The catheter was inserted to the cephalic vein in the deltopectoral groove, in which connected to the port pocket implanted in the anteromedial thorax. This modified technique had more stable location of port, more fixed area if compared with deltopectoral groove, and easily access for non-coring needle insertion. By connecting both sides, the position of catheter would be horizontal and easily palpable, which minimalizing the risk of catheter being twisted and kinked. Conclusion: this modification technique was safe and useful. The long-term outcome was satisfactorily good by this technique without any major and minor events.

Key words: TIVAPs, cephalic vein, anteromedial thorax