Implanting totally implantable venous access ports in the upper arm is feasible and safe for patients with early breast cancer

Abstract

Purpose: Totally implantable venous access ports are widely used in chemotherapy for malignant tumors. This retrospective study investigated the safety, technical feasibility, and device-related complications of totally implantable venous access ports implanted in the upper arm. Methods: Between May 2016 and June 2018, 570 women with early breast cancer received chemotherapy and were successfully implanted with a totally implantable venous access port in the upper arm. Device-related complications were collected and influencing factors were analyzed for major complications. Results: Only one case underwent premature port removal before the end of chemotherapy. Device-related complications were observed in 32 cases, including 31 late complications. The rate of complications was 0.263/1000 catheter-days. Infection and thrombosis were the most common complications, occurring in 13 and 8 cases, respectively. Other complications were catheter occlusion, catheter dislocation, arrhythmia, and so on. Patients with higher body mass index were significantly more prone to infection and those who experienced catheter-related thrombosis had longer implantation times and higher body mass indices. Conclusion: Implanting totally implantable venous access ports in the upper arm is feasible and safe for patients with early breast cancer, with a low rate of complications, providing good alternative to central venous ports.

Clinical practice guidelines for breast cancer implantable intravenous infusion ports: Chinese Society of Breast Surgery practice guidelines 2021

“…In the literature, the long-term use of internal jugular vein implantation for the infusion port is more effective and safer than that for the subclavian vein. [ 3 ] Femoral vein placement may be appropriate in cases of obstructed compression of the superior vena cava or other special circumstances. [ 4 ] The arm port provides a better patient experience than the chest wall port because the placement site is hidden and there are no problems with changing the patient's dressing habits and exposing the implanted port site.…”

A retrospective observational study on maintenance and complications of totally implantable venous access ports in 563 patients: Prolonged versus short flushing intervals

“…In recent years, the use of TIVAPs, which are designed to permit repeated injections, infusions, and, optionally, blood sampling, has become increasingly frequent in oncology settings [ 1 , 2 ]. The TIVAP is a device located entirely under the dermis that contains a subdermal reservoir accessed through the dermis using a needle and a catheter that extends to the central vein [ [3] , [4] , [5] ]. It has a better cosmetic appearance and less influence on the patient’s daily life and produces higher patient satisfaction than other options [ 6 ].…”

Ultrasound-Guided Totally Implantable Venous Access: Comparison between Arm and Chest Ports in Solid Organ Cancer Patients

“…(5) In addition, many patients are uncomfortable about having a port inserted in the chest wall, especially breast cancer patients with large lesions. (5,6) Recently, there has been an increase in the use of implantable ports in the arm, especially in breast cancer patients, because of the simplicity of the procedure and cosmetic superiority. (2,6) However, few clinical trials have investigated the safety and stability of the procedure in various types of cancers.…”

“…(5,6) Recently, there has been an increase in the use of implantable ports in the arm, especially in breast cancer patients, because of the simplicity of the procedure and cosmetic superiority. (2,6) However, few clinical trials have investigated the safety and stability of the procedure in various types of cancers. Other studies have reported that arm ports have a higher rate of complications than chest ports, especially with regard to catheter-induced thrombosis.…”

“…The most used vein for the TIVAPs procedure is the internal jugular vein, and a port is inserted in the upper portion of the anterior chest wall. However, patients who have undergone breast cancer surgery or have head and neck cancer tend to pose challenged for insertion or reluctant to use these traditional methods (2,6,7). In such situations, an arm port can be an alternative method.…”