Subcutaneous Venous Port Implantation in Patients with Bilateral Breast Surgery

Abstract

The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time of surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up.

Tailored approach to the choice of long-term vascular access in breast cancer patients

“…It is important to preserve venous flow and prevent lymphedema in patients with breast cancer after insertion of the port via the ipsilateral arm or subclavian vein [21,22]. In addition, TIVADs on the ipsilateral chest or neck are best avoided in patients with breast, lung, or head and neck malignancy requiring radiation therapy [22]. In our series, PICCs or arm ports could be a safe option when the contralateral arm was selected, especially in patients who underwent axillary lymph node dissections.…”

“…Particularly breast cancer patients in whom axillary dissection has been performed have an increased risk of lymphedema and possible cellulitis after arm catheterization. It is important to preserve venous flow and prevent lymphedema in patients with breast cancer after insertion of the port via the ipsilateral arm or subclavian vein [21,22]. In addition, TIVADs on the ipsilateral chest or neck are best avoided in patients with breast, lung, or head and neck malignancy requiring radiation therapy [22].…”

Femoral Port Placement – Report of Two Cases

“…Hence, in both cases, basilic approach was not used. Another approach is midline or parasternal placement of the port [4]. This approach was not used due to lack of adequate subcutaneous tissue in that area and scarring.…”

Dislocation of Intravenous Port Systems – Three Case Reports

“…Intravenous port systems can be implanted in different locations: either in the infraclavicular region via the subclavian vein or in the forearm via the vena brachialis [2]. The injec- tion port reservoir is located subcutaneously and is connected with the actual port catheter which reaches intravenously into the vena cava superior just above the atrium of the right heart [3].…”