Incidence and Management of Catheter Occlusion in Implantable Arm Ports: Results in 391 Patients

Whigham, Cliff J.; Greenbaum, Marianne C.; Fisher, Richard G.; Goodman, Chad J.; Thornby, John; Thomas, John W.

doi:10.1016/s1051-0443(99)70112-0

Cited by 21 publications

(8 citation statements)

References 20 publications

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“…Alternativ zur zentral-venösen Kathetereinlage wird zudem die Möglichkeit der peripher-venösen Implantation des so genannten PAS-Port-Systems beschrieben.Die Kathetereinlage erfolgt über Vv.sectio der V.cephalica am Oberarm.In den publizierten Arbeiten wurden ebenfalls Silikonkatheter ohne technisch erforderlichen Richtungswechsel durch Muskelpassage und "Schlaufenlegung" verwandt. Katheterbrüche wurden auch hier nie beobachtet [6,10,25,27,30]. Der Nachteil dieser peripheren Implantationstechnik liegt jedoch in einer höheren intravasalen Thrombosebildung von 4,5% [6] im Vergleich zur zentral-venösen V.-subclavia-Punktionstechnik, wo sie mit 1,3% angegeben wird [20] und außerdem in einem hö-heren Prozentsatz von Katheterokklusionen (7% [25] bis 22,9% [30]) im Vergleich zur oben genannten Technik (1,9%) [21].…”

Section: Ergebnisseunclassified

“…Katheterbrüche wurden auch hier nie beobachtet [6,10,25,27,30]. Der Nachteil dieser peripheren Implantationstechnik liegt jedoch in einer höheren intravasalen Thrombosebildung von 4,5% [6] im Vergleich zur zentral-venösen V.-subclavia-Punktionstechnik, wo sie mit 1,3% angegeben wird [20] und außerdem in einem hö-heren Prozentsatz von Katheterokklusionen (7% [25] bis 22,9% [30]) im Vergleich zur oben genannten Technik (1,9%) [21].…”

Section: Ergebnisseunclassified

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Portkatheterbrüche bei 361 implantierten Portsystemen Ursachenanalyse – Lösungsmöglichkeiten – Literaturübersicht

Leinung

Würl

Anders

et al. 2002

Chirurg

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We registered 48 complications altogether (15.4% of 311), 21(6.7%) of which occurred immediately after implantation (up to 30 days postoperatively). These could be divided either into wound-healing disorders/pulmonary distress (4.5%, n = 14) or complications concerning the catheter systems (2.3%, n = 7). Long-term complications after 31 days were evident in 27 patients (8.7%), due either to infections (4.5%, n = 13) or catheter-associated problems (4.5%, n = 14). Catheter lesions occurred in nine cases (2.9% out of 311) at the point of entry into the musculus pectoralis, i.e., where the catheter had to change direction. Typically these were lengthways tears caused by the catheter. We observed one full breakage without dislocation, and two dislocated catheter fragments in the systemic circulation. We consider the change of direction to be responsible for wear on the silicon catheter. During implantation, extreme change of direction of the catheter should be avoided because this is where breakage happens. Catheter implantation by means of exposure of the vena basilica in the infraclavicular triangle is the method of choice.

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Section: Ergebnisseunclassified

Portkatheterbrüche bei 361 implantierten Portsystemen Ursachenanalyse – Lösungsmöglichkeiten – Literaturübersicht

Leinung

Würl

Anders

et al. 2002

Chirurg

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“…7,13,14,[32][33][34] A trial comparing mechanical manipulation versus catheter exchange showed that tunneled hemodialysis catheters with over-the-wire exchange is superior to percutaneous fibrin sheath stripping in short-and long-term (4 months) patency rates. 18 Gray et al compared mechanical manipulation versus thrombolysis and demonstrated that urokinase in central dialysis catheters is equal to fibrin sheath stripping in the short term (45 days).…”

Section: Discussionmentioning

confidence: 99%

Local Low-Dose Thrombolysis for Safe and Effective Treatment of Venous Port-Catheter Thrombosis

et al. 2014

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“…However, if there is a thrombosis within or around the catheter other steps may be used. Systemic or local instillation of fibrinolytic agents can be successful in up to 80% of these patients, reestablishing total venous recanalization [1,10,27,31,35]. When there is primary subclavian vein thrombosis there may be satisfactory resolution of the symptoms with the use of anticoagulants alone, while avoiding the risk and cost of catheter replacement or use of fibrinolytic agents [17,27].…”

Section: Introductionmentioning

confidence: 99%

Management of nonfunctional central venous catheters

Bern¹,

Halloran²,

Anderson³

et al. 2011

Int J Angiol

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Management of non-functional central venous catheters traditionally involves instillation of fibrinolytic agents, and if unsuccessful, removal and replacement of the catheter. Many of these catheters, however, are still usable for their original purposes. With time, collateral vessels open, allowing passage of fluids into the circulation. We attempted to preserve such catheters if they were not fractured and were not used for infusing sclerosing agents. In 75 patients, there were 91 occlusive events. Venograms, cathetergrams, or ultrasounds were used to detect the cause of catheter failure, searching for sheath thrombus, subclavian vein or superior vena cava thrombosis. Of the 75 patients, 9 had recurrent failures after original resolution. In 5, the catheter was removed due to sepsis. Therefore the total events available for analysis was 86. The various medical treatments included warfarin, heparin, low molecular weight heparin (LMWH) and fibrinolytics, and passage of time. Overall, 49 events were resolved. For 38 of these 49 events associated signs and symptoms resolved within one week. Thirty-four (34) catheters were removed due to persistent problems, including sepsis in 5. In 22 patients, the catheters remained functional until the patient's death, and in 14 the catheters remained functional until completion of the patient's therapy. Therefore, over half (54%) of the catheters associated with veno-occlusive events can be maintained with these medical approaches. Selective medical management should be applied to non-functioning central venous catheters to avoid added risk, inconvenience, and cost of their replacement.

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Incidence and Management of Catheter Occlusion in Implantable Arm Ports: Results in 391 Patients

Cited by 21 publications

References 20 publications

Portkatheterbrüche bei 361 implantierten Portsystemen Ursachenanalyse – Lösungsmöglichkeiten – Literaturübersicht

Portkatheterbrüche bei 361 implantierten Portsystemen Ursachenanalyse – Lösungsmöglichkeiten – Literaturübersicht

Local Low-Dose Thrombolysis for Safe and Effective Treatment of Venous Port-Catheter Thrombosis

Management of nonfunctional central venous catheters

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