Peripheral venous access ports: Outcomes analysis in 109 patients

Bodner, Leonard; Nosher, John L.; Patel, Kaushik M.; Siegel, Randall L.; Biswal, Rajiv; Gribbin, C; Tokarz, Robert

doi:10.1007/s002700010041

Cited by 64 publications

(54 citation statements)

References 24 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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“…Der Altersdurchschnitt der Patienten in dieser Arbeit liegt bei 58,6 Jahren und rangiert damit im oberen Altersbereich im Vergleich zu anderen Veröffentlichungen. Hier reichen die Angaben des durchschnittlichen Alters von 49 Jahren [12] bis zu 59,4 Jahren [13].…”

Section: Diskussionunclassified

“…einer Verwendung von implantierten Geräten und längerfristig verweilenden Kathetern auftreten. Dazu gehören unter anderem Infektionen, Geräteerosionen, Hämatome und Nachblutungen, Ausstoßung oder Abstoßung des [13]. Je nach Ausmaß der Infektion sollte entsprechend behandelt werden.…”

Section: Diskussionunclassified

Wie sollen Urologen venöse subkutane Portsysteme implantieren?

Schenck

Michels-Oswald

Tschirdewahn

et al. 2011

Urologe

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Implantation of port systems with ECG control of the catheter tip position is related to a few cases of adverse events and good surgical outcomes. Furthermore, it has also shown great advantages in offering immediate support and early therapy initiation with a fast learning curve for the training urologists. The results of the presented analysis are comparable to those of surgical or radiological departments reported in the literature and provide good evidence that this procedure should be extended to urological centers with a high volume of chemotherapy patients.

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“…In other reports, rates have ranged from 3.7% to 28% [1,3,11]. The most prevalent cause of CV port thrombotic obstruction is insufficient flushing after drip infusion or aspiration of blood through the CV port, and blood reflux during drip infusion due to insufficient device fixation [12].…”

Section: Discussionmentioning

confidence: 99%

A Dual-Needle Pumping Technique for Unblocking an Obstructed Central Venous Access Port

Tsuboi

Yamagami

Tsuboi

2017

Interventional Radiology

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PURPOSE: To evaluate the usefulness and safety of the dual-needle pumping technique" for central venous access port (CV port) obstruction due to thrombus or fibrin sheath formation.PATIENTS AND METHODS: For 25 patients who had a CV port obstruction due to thrombus or fibrin sheath formation between 2001 and 2016, we performed the dual-needle pumping technique." The operator inserted two coreless needles in the port and alternately pumped the plungers of two syringes filled with distilled water or urokinase (UK) solution.RESULTS: Overall, we achieved recanalization in 22 patients (88%). In 6 patients, success in recanalization was achieved by using distilled water only, while in 2 patients, failure occurred by using distilled water only before changing to the UK solution to achieve recanalization. Success in recanalization was attained in 14 patients by using the UK solution from the beginning. In 3 patients, the CV port system was withdrawn because the obstruction could not be removed. No complications occurred in relation to this procedure.CONCLUSION: For removing an obstruction in the CV port system, the dual-needle pumping technique" is a reasonable option to avoid system replacement. Thus, this procedure is considered useful and safe.

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Peripheral venous access ports: Outcomes analysis in 109 patients

Abstract: Peripheral ports for long-term central venous access placed by interventional radiologists in the interventional radiology suite are as safe and as effective as chest ports.

Cited by 64 publications

References 24 publications

Portkatheterbrüche bei 361 implantierten Portsystemen Ursachenanalyse – Lösungsmöglichkeiten – Literaturübersicht

Portkatheterbrüche bei 361 implantierten Portsystemen Ursachenanalyse – Lösungsmöglichkeiten – Literaturübersicht

Wie sollen Urologen venöse subkutane Portsysteme implantieren?

A Dual-Needle Pumping Technique for Unblocking an Obstructed Central Venous Access Port

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