Catheter-related Complications of Subcutaneous Implantable Venous Access Devices in Breast Cancer Patients

El‐Balat, Ahmed; Schmeil, Iryna; Karn, Thomas; Holtrich, Uwe; Mavrova-Risteska, Loreta; Rody, Achim; Youssef, A.; Hanker, Lars

doi:10.21873/invivo.11377

Cited by 17 publications

(14 citation statements)

References 23 publications

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“…The rate of TIVAD-related thrombosis found in this study (4.1%) is within the range of 1.5 up to 16.4% reported in the current literature [2,5,11,[13][14][15][16][17][18]. Likewise, the observed incidence of the complication "venous malposition" (3.1%) is in line with previous studies [13,[16][17].…”

Section: Discussionsupporting

confidence: 91%

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Catheter-related Complications with Totally Implantable Venous Access Devices in Patients with Gynecologic Malignancies

Ernst

Bärtels

Gregorio

et al. 2021

Preprint

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Background: The implantation of a subcutaneous implantable venous access device in patients with a gynecological cancer disease could be necessary because of different causes, e.g. application of chemotherapy or parenteral nutrition in case of advanced cancer. 4 years after implementation of the Seldinger-technique in the subclavian vein as standard way of port-catheter-implantation at department of gynecology at the University-Hospital in Ulm a retrospective analysis of complication-rates was performed to define internal standards for this procedure. Methods: Between 01/2014 and 07/2018 we reviewed all patients who received a port implantation at the gynecological department. The standard way of port-implantation used in this cohort was Seldinger-technique. All Data assessed were used anonymously. Patients-characteristics, tumor-entity, surgical and anesthesiological management, morbidity and port catheter associated complications (thrombosis, infections etc.) were analyzed. Results: A total of 638 were included. The implantation was performed in Seldinger-technique. Port catheter implantation was successfully performed in 96.6%. The implantation on the left subclavian vein significantly showed a higher rate of success than in the right subclavian vein (98.2% vs. 95.3%, p=0,036). Significant higher rates of associated thromboses was found in patients with a port implantation on the left side (5.9% vs. 2.0%; p=0.036). Obesity (BMI ≥ 30 kg/ m2) leads to a significant higher rate of venous misplacements (p=0.027). Compared to local anesthesia and analgosedation, general anesthesia leads to a significant lower rate of perioperative complications (20.3% vs. 22.4% vs. 13.1%; p=0.014). Perioperative application of antibiotics seems to reduce postoperative infection rates, even if the results are not significant. Conclusion: Seldinger-Technique is an efficient way for port-implantation. Especially patients with a high potential of complications, like obesity with BMI >30kg/m², or other risk factors, the left subclavian vein should be preferred, as well as general anesthesia. Perioperative application of antibiotics (e.g. single-shot antibiotics) should be considered. Trial registration: retrospectively registered

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Section: Discussionsupporting

confidence: 91%

“…However, the preferred method for catheter implantation was CT and ST was only used in case of a failed implantation by CT. The observed overall complication rate was 26% and thus considerably higher compared to our study (18%) [14].…”

Section: Discussioncontrasting

confidence: 75%

Catheter-related Complications with Totally Implantable Venous Access Devices in Patients with Gynecologic Malignancies

Ernst

Bärtels

Gregorio

et al. 2021

Preprint

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“…In the previous literature, the major PC-related complications are infection and VTE, which could lead to the removal of PC. The incidence for PC-related infection is approximately 3-12%, 9,25 while that incidence for VTE is about 11-15% at 6 months. 14,26 In our study, our data show that incidence for major complications of intraoperative PC implantation is similar to conventional PC implantation.…”

Section: Discussionmentioning

confidence: 98%

“…8 To date, the peripherally inserted central catheter (PICC) and Port catheter (PC) have been the major two standard devices used in this indication. 9,10 PICC can be easily inserted and removed, but it needs maintenance at least once a week. PC is another classical route of administering chemotherapy, which provides deep venous access and allows for iterative perfusions, even for years.…”

Section: Etcmentioning

confidence: 99%

“…A central venous device is normally required for the administration of adjuvant chemotherapy to avoid peripheral venous punctures and venous toxicities 8 . To date, the peripherally inserted central catheter (PICC) and Port catheter (PC) have been the major two standard devices used in this indication 9,10 . PICC can be easily inserted and removed, but it needs maintenance at least once a week.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative ipsilateral subclavian port catheter implantation in resectable breast cancer patients: A novel, safe, and convenient clinical practice

Liu

et al. 2020

Cancer Medicine

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Background Port catheter (PC) is a classical route of administering chemotherapy for breast cancer patients. We established a standard operating procedure (SOP) of intraoperative ipsilateral subclavian PC implantation in selected resectable breast cancer patients. Methods We conducted a prospective clinical study to assess its safety and complications. A total of seventy six resectable breast cancer patients were included for intraoperative ipsilateral subclavian PC implantation. Thirty patients receiving conventional percutaneous contralateral PC implantation under local anesthesia at the same period were recruited as control group. The time consuming of implantation, and PC‐related complications were recorded. Visual analog scale questionnaires were used to assess patients’ satisfaction. Results Compared with conventional contralateral PC implantation under local anesthesia, SOP for intraoperative ipsilateral subclavian PC implantation significantly shortens the time consuming (11.6 vs. 28.6 min, p < 0.001). With a median retention time of 6.3 months, the overall incidence rate of PC‐related complications is 21%, of which the most common complications are infections and venous thromboembolism (7.9% for each). Most patients (86.8%) with intraoperative ipsilateral subclavian PC implantation have completed the whole chemotherapy successfully. Due to the general anesthesia and shorter time consuming, intraoperative implantation gains significantly more patients' satisfaction. Conclusions In the present study, we develop a SOP for intraoperative ipsilateral subclavian PC implantation in resectable breast cancer patients, which is noval, convenient, and safe. In selected breast cancer patients with indications for adjuvant chemotherapy, this practice could significantly shorten the time consuming of PC implantation and improve the degree of patients' satisfaction.

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Reduction of perioperative venous thrombus formation by antithrombotic peripherally inserted central catheter in esophageal cancer

Nanishi

Konishi

Shiozaki

et al. 2021

Langenbecks Arch Surg

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Catheter-related Complications of Subcutaneous Implantable Venous Access Devices in Breast Cancer Patients

Abstract: TIVAD implantation done in a gynecological outpatient setting is feasible and safe.

Cited by 17 publications

References 23 publications

Catheter-related Complications with Totally Implantable Venous Access Devices in Patients with Gynecologic Malignancies

Catheter-related Complications with Totally Implantable Venous Access Devices in Patients with Gynecologic Malignancies

Intraoperative ipsilateral subclavian port catheter implantation in resectable breast cancer patients: A novel, safe, and convenient clinical practice

Reduction of perioperative venous thrombus formation by antithrombotic peripherally inserted central catheter in esophageal cancer

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