Outcomes of surgical and radiologic placed implantable central venous access ports

Sticca, Robert P.; Dewing, Bree D.; Harris, Joel D.

doi:10.1016/j.amjsurg.2009.04.031

Cited by 28 publications

(27 citation statements)

References 3 publications

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“…Our data indicate that port-a-cath placement is an effective route for the administration of chemotherapy and other agents over several days and over several courses of chemotherapy. The mean duration of use was more than a year (389 days), which is similar to findings of several other studies (range 181-596) [3,10,[15][16][17], though higher than what was reported by an Italian study (168 days) [5]. The mean duration of use was much better in our study compared to a study from Pakistan in which port-a-caths were inserted in 55 patients (153 days vs. 354.4 days).…”

Section: Discussionsupporting

confidence: 89%

“…Infection (21 port-a-caths, 17.9%) was the most common complication for the premature removal of the port-a-cath, which is much higher than other studies, which ranged from 1.7% to 9.3% [1,3,6,9,10,14,18]. A total of 85 port-a-caths were placed between 2010 and 2013, while only 14 were inserted in the three preceding years, from January 2007 through December 2009.…”

Section: Discussionmentioning

confidence: 78%

“…However, the procedure and its subsequent maintenance are not free of side effects; infections, hematoma, malpositioning, pneumothorax, thrombosis/blockage, embolization, and catheter fracture remain important complications associated with TIVAP [1,2,8,9]. Over the course of the past decade, reports suggest that the complication rate has decreased with improved techniques and material [10].…”

Section: Introductionmentioning

confidence: 99%

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Use of port-a-cath in cancer patients: a single-center experience

Dsouza

Kumar

Kakaria

et al. 2014

J Infect Dev Ctries

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Introduction: Central venous catheters play an important role in the management of cancer patients. Different types of devices are associated with different patterns of complications. We report on the pattern of use and rate of complications of port-a-caths in patients diagnosed with malignant cancer at a single institution. Methodology: The data were collected retrospectively from patients who received the treatment for solid tumors or lymphoma through a porta-cath at the Sultan Qaboos University Hospital (SQUH) between January 2007 and February 2013. Results: A total of 117 port-a-caths were inserted in 106 patients. The majority (86; 73.5%) were implanted by an interventional radiologist, and the right internal jugular vein was accessed in 79 (67.5%) patients. Mean catheter indwelling time was 354 (range 3-1,876) days for all patients, 252 (3-1,876) and 389 days (13-1,139) for patients with and without complications, respectively. Thirty (25.6%) port-a-caths were removed prematurely, mainly due to infectious complications, while 17 (14.5%) were removed after completion of treatment. Staphylococcus aureus was the most frequently isolated organism, found in 8 (6.8%) patients. Underlying diagnosis (p < 0.001), chemotherapy regimen (p < 0.001), sensitivity to antibiotics (p = 0.01), and any complication (p < 0.001) were significant factors affecting the duration of port-a-cath use. None of these factors were significant on multivariate cox regression analysis. Conclusions: The mean duration of port-a-cath use was almost one year. Infection was the most common complication leading to premature removal, followed by port thrombosis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Use of port-a-cath in cancer patients: a single-center experience

Dsouza

Kumar

Kakaria

et al. 2014

J Infect Dev Ctries

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“…6 Furthermore, the discovery of peel-away sheaths allowed TIVAD implantation with Seldinger technique. 7,20 In literature, surgical TIVAD implantation using Seldinger/landmark/cutdown techniques with the SCV or IJV had a complication rate varying between 4% and 24.6% (18,(21)(22)(23)(24)(25)(26). Image guidance with fluoroscopy and ultrasound for IJV or SCV puncture provided a higher technical success rate and low risk of periprocedural complications compared to the surgical technique.…”

Section: Late Postprocedural Complicationsmentioning

confidence: 99%

“…Image guidance with fluoroscopy and ultrasound for IJV or SCV puncture provided a higher technical success rate and low risk of periprocedural complications compared to the surgical technique. 13,23,[27][28][29][30][31] Right IJV is the preferred site for TIVAD implantation by the interventional radiologists because of its straight course that reduces catheter complications like thrombosis and low risk of catheter pinch-off phenomen between the first rib and the clavicle. [32][33][34][35] Femoral veins are usually not preferred for puncture however it might be advantageous in conditions like tumoral involvement or stenosis/thrombosis of superior vena cava and puncture problems related to low central venous pressure or obesity.…”

Section: Late Postprocedural Complicationsmentioning

confidence: 99%

A Comparative Study of Low-Profile and Regular Type Totally Implantable Venous Access Devices in Patients with Malignant Tumors: Retrospective Analysis of 4501 Implantations.

Akmangit¹

2014

UHOD

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The purpose of this study was to evaluate safety and efficacy of image-guided radiological totally implantable venous access devices with special reference to rate of skin complications of both regular and low-profile types. 4395 patients were referred to Interventional Radiology Unit between March 2003-September 2013. 4501 implantations of totally implantable venous access device were performed in patients under sonography and fluoroscopy. During this period 2299 regular-type and 2202 low-profile type totally implantable venous access devices were used. Success rate, periprocedural early and long-term complications were evaluated. Periprocedural and early complications of totally implantable venous access devices included 16 (0.4%) arterial punctures, 101 (2.2%) minor hematoma, 1 (%0.02) disconnection of the catheter, 4 (0.09%) septum separation, 38(0.8%) minor erythema-pain and tenderness, 23 (0.5%) short term fever without bacteriemia and 25 (0.6%) inversion of the port. Late complications included 6(0.1%) cellulitis, 8 (0.2%) bacteriemia and sepsis, 305 (6.8%) venous thrombosis, 62 (1.4%) catheter thrombosis, 6 (0.1%) catheter migration and 3 (0.07%) catheter fracture. A total of 53 (1.18%) skin perforation were seen. There was statistically significant difference between regular and low-profile totally implantable venous access devices particularly in patients with normal and thinner subcutaneous fat tissue (p= 0.024 and <0.001 respectively). The present study is the largest series in the literature in patients with malignant tumors. Image-guided radiological totally implantable venous access device placement is safe and reliable method with a low risk of complications and the results of this study further justify the use of low profile totally implantable venous access device based on lower skin complications. Keywords: Port, TIVAD, Low-profile, Regular, Skin perforation ÖZET Malign Tümörlü Olgularda Düşük Profilli ve Standard Tip TİVEC kullanımının Karşılaştırmalı Çalışması: 4501 Olgunun Retrospektif AnaliziBu çalışmanın amacı radyolojik görüntüleme eşliğinde yerleştirilen, standart ve düşük profilli, tamamen implante edilebilir venöz erişim cihazlarının cilt komplikasyonları yönünden güvenirlik ve etkinliğinin değerlendirilmesiydi. Mart 2003 ve Eylül 2013 tarihleri arasında 4395 hasta Girişimsel Radyoloji ünitesine başvurdu. Bu hastalara ultrasonografi ve floroskopi eşliğinde 4501 tamamen implante edilebilir venöz erişim cihazı yerleştirildi. Bu süre içinde 2299 standard tipte, 2202 düşük profilli tamamen implante edilebilir venöz erişim cihazı kullanıldı. Başarı oranı, işlem sırasında, erken ve geç komplikasyonlar değerlendirildi. Tamamen implante edilebilir venöz erişim cihazı yerleştirilmesi sırasında gelişen erken dönem komplikasyonlar arteriel giriş 16 (%0.4), minör hematom 101 (%2.2), kateter ayrılması 1 (%0.02), septum ayrılması 4 (%0.09), minör eritem-ağrı ve hassasiyet 38 (%0.8), bakteriyemi olmaksızın kısa süren ateş 23 (%0.5) ve portun ters dönmesi 25 (%0.6) olarak sıralandı. Geç kompl...

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Removal of Totally Implantable Venous Access Device

LaBella

Tang²

2012

Totally Implantable Venous Access Devices

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Outcomes of surgical and radiologic placed implantable central venous access ports

Cited by 28 publications

References 3 publications

Use of port-a-cath in cancer patients: a single-center experience

Use of port-a-cath in cancer patients: a single-center experience

A Comparative Study of Low-Profile and Regular Type Totally Implantable Venous Access Devices in Patients with Malignant Tumors: Retrospective Analysis of 4501 Implantations.

Removal of Totally Implantable Venous Access Device

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