Follow-Up of Radiologically Totally Implanted Central Venous Access Ports of the Upper Arm: Long-Term Complications in 127,750 Catheter-Days

Abstract

Radiologic placement of a totally implanted central VAP is a safe procedure with a low rate of both early and late device-related complications. The method is effective for delivery of chemotherapy, parenteral nutrition, and frequent IV medication.

Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan

“…The overall complication rates in the chest (7.4 %) and neck (6.8 %) groups reported in this study are similar to those mentioned in a previous report regarding complication rates of central venous catheterization by site [10]. Furthermore, although related studies regarding sites other than the chest and neck are scarce, our results concerning the incidence of complications stratified by CVPI sites/methods are similar to those of previous reports [19,23,[25][26][27][28][29][30][31].…”

Ultrasound-Guided Arm Ports: Indications, Techniques, and Management

“…9 Median nerve compression requiring device explantation has been reported in 0.1% to 0.6% of procedures. 7,9 Usually, the cephalic vein is nondominant and remains the last option of arm target vein access, owing to the 10-fold risk of reported phlebitis compared with basilic or brachial veins. 14 Moreover, cephalic vein arch catheterization can also be challenging particularly when using Groshong valved catheters.…”

“…[7][8][9] Compared with the 0.8% chest port pinchoff rate, 18 arm port devices are more exposed to repetitive mechanical microtraumas of the upper limb. In case of a loose subcutaneous tunneled catheter, arm abduction induces a subcutaneous curve that disappears when the arm shifts back close to the torso.…”

“…7,9 As a matter of fact, partial twisting may occur during prolonged perfusion. Drug extravasation might occur during overnight chemotherapy or during agitation/confusion in 0.2% of oncology patients.…”

“…[3][4][5] Thirty years later, the largest series in the literature shows that arm port device techniques are safe and effective. [6][7][8][9] Because ultrasound (US) guidance is available worldwide, is cost-effective, and reduces the technical failure rate of percutaneous vein access, 10 this review reports the technical aspects, main complications, and dedicated indications of arm ports inserted under US guidance.…”