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Systematic review: malfunction of totally implantable venous access devices in cancer patients

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Abstract

Purpose

Malfunction of totally implantable venous access devices is a common complication. The purpose was to identify definitions used to describe malfunction and to investigate the incidence of malfunction in different types of port and catheter designs.

Methods

Relevant studies were identified in PubMed that were published between January 1993 and February 2011. Empirical studies reporting functional outcomes in adults and where, at least 95% of the studied population consisted of onco-hematology patients with a newly inserted chest or arm port, were selected. The following data were extracted: patient and totally implantable venous access devices (TIVAD) characteristics, study design, definitions of malfunction, and functional outcomes. Two independent reviewers assessed the methodological quality of the series.

Results

Of the 4,886 potentially relevant articles, 57 were selected, involving 14,311 TIVADs. Twenty-nine percent of the studies explicitly defined malfunction. Malfunction incidence rates were expressed in six different ways, including the proportion of affected devices per inserted devices (incidence 0–47%); the number of affected devices per 1,000 catheter days (incidence 0–2.24 per 1,000 catheter days); and the number of malfunctions over the total number of accessing attempts (incidence 0–26%).

Conclusions

Heterogeneity in the definitions used to describe device malfunction was evident. A broad range in the reported incidence of malfunction and in the kind of calculation and reporting methods was also found. Methodological quality of the studies was often poor. Standardization of definitions and accurate outcome measurement is needed. Calculation and report of malfunction incidence should be based on prospective data collected at the moment of an accession attempt.

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References

  1. Akahane A, Sone M, Ehara S, Kato K, Tanaka R, Nakasato T (2010) Subclavian vein versus arm vein for totally implantable central venous port for patients with head and neck cancer: a retrospective comparative analysis. Cardiovasc Intervent Radiol. doi:10.1007/s00270-010-0051-4

    PubMed  Google Scholar 

  2. Araujo C, Silva JP, Antunes P, Fernandes JM, Dias C, Pereira H, Dias T, Fougo JL (2008) A comparative study between two central veins for the introduction of totally implantable venous access devices in 1201 cancer patients. Eur J Surg Oncol 34:222–226

    PubMed  CAS  Google Scholar 

  3. Biffi R, De Braud F, Orsi F, Pozzi S, Arnaldi P, Goldhirsch A, Rotmensz N, Robertson C, Bellomi M, Andreoni B (2001) A randomized, prospective trial of central venous ports connected to standard open-ended or Groshong catheters in adult oncology patients. Cancer 92:1204–1212

    Article  PubMed  CAS  Google Scholar 

  4. Biffi R, De Braud F, Orsi F, Pozzi S, Mauri S, Goldhirsch A, Nole F, Andreoni B (1998) Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 9:767–773

    Article  PubMed  CAS  Google Scholar 

  5. Biffi R, Martinelli G, Pozzi S, Cinieri S, Cocorocchio E, Peccatori F, Ferrucci PF, Pistorio R, Andreoni B (1999) Totally implantable central venous access ports for high-dose chemotherapy administration and autologous stem cell transplantation: analysis of overall and septic complications in 68 cases using a single type of device. Bone Marrow Transplant 24:89–93

    Article  PubMed  CAS  Google Scholar 

  6. Biffi R, Pittiruti M, Gillet JP, Fobe D, Hermanne JP, Pescio M, Gourlia A, Collet K, Battelli C, Cenciarelli S (2002) Valved central venous catheter connected to subcutaneous port: a multicenter phase IV study based on a cohort of 50 oncology patients. J Vasc Access 3:147–153

    PubMed  CAS  Google Scholar 

  7. Bodner LJ, Nosher JL, Patel KM, Siegel RL, Biswal R, Gribbin CE, Tokarz R (2000) Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Interv Radiol 23:187–193

    Article  CAS  Google Scholar 

  8. Brown DF, Muirhead MJ, Travis PM, Vire SR, Weller J, Hauer-Jensen M (1997) Mode of chemotherapy does not affect complications with an implantable venous access device. Cancer 80:966–972

    Article  PubMed  CAS  Google Scholar 

  9. Burbridge B, Krieger E, Stoneham G (2000) Arm placement of the cook titanium Petite Vital-Port: results of radiologic placement in 125 patients with cancer. Can Assoc Radiol J 51:163–169

    PubMed  CAS  Google Scholar 

  10. Caers J, Fontaine C, Vinh-Hung V, De Mey J, Ponnet G, Oost C, Lamote J, De Greve J, Van Camp B, Lacor P (2005) Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support Care Cancer 13:325–331

    Article  PubMed  Google Scholar 

  11. Carlo JT, Lamont JP, McCarty TM, Livingston S, Kuhn JA (2004) A prospective randomized trial demonstrating valved implantable ports have fewer complications and lower overall cost than nonvalved implantable ports. Am J Surg 188:722–727

    Article  PubMed  Google Scholar 

  12. Carre MC, Lopez Vega JM, Carles J, Lizon J, Villar A, Lera SA, Alastrue A, Rull M, Van der HC, Aguilo J (1994) Central venous brachial catheter (P.A.S. Port TM) and catheter scanning system (Cath-Finder TM). J Surg Oncol 55:190–193

    Article  PubMed  CAS  Google Scholar 

  13. Chang HM, Hsieh CB, Hsieh HF, Chen TW, Chen CJ, Chan DC, Yu JC, Liu YC, Shen KL (2006) An alternative technique for totally implantable central venous access devices. A retrospective study of 1311 cases. Eur J Surg Oncol 32:90–93

    Article  PubMed  CAS  Google Scholar 

  14. Chen PT, Sung CS, Wang CC, Chan KH, Chang WK, Hsu WH (2007) Experience of anesthesiologists with percutaneous nonangiographic venous access. J Clin Anesth 19:609–615

    Article  PubMed  Google Scholar 

  15. Conessa C, Talfer S, Herve S, Chollet O, Poncet JL (2002) Cephalic vein access for implantable venous access devices. Technique and long-term follow-up. Rev Laryngol Otol Rhinol (Bord) 123:143–148

    Google Scholar 

  16. Cunningham MJ, Collins MB, Kredentser DC, Malfetano JH (1996) Peripheral infusion ports for central venous access in patients with gynecologic malignancies. Gynecol Oncol 60:397–399

    Article  PubMed  CAS  Google Scholar 

  17. de Gregorio MA, Miguelena JM, Fernandez JA, de Gregorio C, Tres A, Alfonso ER (1996) Subcutaneous ports in the radiology suite: an effective and safe procedure for care in cancer patients. Eur Radiol 6:748–752

    Article  PubMed  Google Scholar 

  18. Dede D, Akmangit I, Yildirim ZN, Sanverdi E, Sayin B (2008) Ultrasonography and fluoroscopy-guided insertion of chest ports. Eur J Surg Oncol 34:1340–1343

    PubMed  CAS  Google Scholar 

  19. Deppe G, Kahn ML, Malviya VK, Malone JM Jr, Christensen CW (1996) Experience with the P.A.S.-PORT venous access device in patients with gynecologic malignancies. Gynecol Oncol 62:340–343

    Article  PubMed  CAS  Google Scholar 

  20. Di Carlo I, Cordio S, La Greca G, Privitera G, Russello D, Puleo S, Latteri F (2001) Totally implantable venous access devices implanted surgically: a retrospective study on early and late complications. Arch Surg 136:1050–1053

    Article  PubMed  Google Scholar 

  21. Estes JM, Rocconi R, Straughn JM, Bhoola S, Leath CA, Alvarez RD, Kilgore LC, Huh WK (2003) Complications of indwelling venous access devices in patients with gynecologic malignancies. Gynecol Oncol 91:591–595

    Article  PubMed  Google Scholar 

  22. Frank JL, Garb JL, Halla B, Reed WP Jr (2001) Ionic implantation of silicone chronic venous access devices does not alter thrombotic complications: a double-blinded, randomized clinical trial. Surgery 129:547–551

    Article  PubMed  CAS  Google Scholar 

  23. Gleeson NC, Fiorica JV, Mark JE, Pinelli DM, Hoffman MS, Roberts WS, Cavanagh D (1993) Externalized Groshong catheters and Hickman ports for central venous access in gynecologic oncology patients. Gynecol Oncol 51:372–376

    Article  PubMed  CAS  Google Scholar 

  24. Goossens GA, Verbeeck G, Moons P, Sermeus W, De Wever I, Stas M (2008) Functional evaluation of conventional 'Celsite' venous ports versus 'Vortex' ports with a tangential outlet: a prospective randomised pilot study. Support Care Cancer 16:1367–1374

    Article  PubMed  CAS  Google Scholar 

  25. Groebli Y, Wutrich P, Safa M, Tschantz P, Callewaert G, Piguet D (1999) Utility and complications of permanent venous access devices (PVAD) in oncological treatments. Follow-up of 100 cases. Panminerva Med 41:89–92

    PubMed  CAS  Google Scholar 

  26. Hartkamp A, van Boxtel AJ, Zonnenberg BA, Witteveen PO (2000) Totally implantable venous access devices: evaluation of complications and a prospective comparative study of two different port systems. Neth J Med 57:215–223

    Article  PubMed  CAS  Google Scholar 

  27. Heibl C, Trommet V, Burgstaller S, Mayrbaeurl B, Baldinger C, Koplmuller R, Kuhr T, Wimmer L, Thaler J (2010) Complications associated with the use of Port-a-Caths in patients with malignant or haematological disease: a single-centre prospective analysis. Eur J Cancer Care (Engl) 19:676–681

    Article  CAS  Google Scholar 

  28. Hoekstra A, Bassot V, Bertoglio S, Bobin JY, Delassus P, Egeli R, Khayat D, Ranchere JY, Santini J, Segol P (1993) Clinical evaluation of the CORDIS vascular access port systems: a multicenter study. Med Oncol Tumor Pharmacother 10:131–138

    PubMed  CAS  Google Scholar 

  29. Jan HC, Chou SJ, Chen TH, Lee CI, Chen TK, Lou MA (2010) Management and prevention of complications of subcutaneous intravenous infusion port. Surg Oncol doi:10.1016/j.suronc.2010.07.001

    PubMed  Google Scholar 

  30. Johansson E, Bjorkholm M, Bjorvell H, Hast R, Takolander R, Olofsson P, Backman L, Weitzberg E, Engervall P (2004) Totally implantable subcutaneous port system versus central venous catheter placed before induction chemotherapy in patients with acute leukaemia-a randomized study. Support Care Cancer 12:99–105

    Article  PubMed  Google Scholar 

  31. Labourey JL, Lacroix P, Genet D, Gobeaux F, Martin J, Venat-Bouvet L, Lavau-Denes S, Maubon A, Tubiana-Mathieu N (2004) Thrombotic complications of implanted central venous access devices: prospective evaluation. Bull Cancer 91:431–436

    PubMed  Google Scholar 

  32. Lemmers NW, Gels ME, Sleijfer DT, Plukker JT, van der Graaf WT, de Langen ZJ, Droste JH, Koops HS, Hoekstra HJ (1996) Complications of venous access ports in 132 patients with disseminated testicular cancer treated with polychemotherapy. J Clin Oncol 14:2916–2922

    PubMed  CAS  Google Scholar 

  33. Lenhart M, Chegini M, Gmeinwieser J, Manke C, Feuerbach S (1998) Radiologic implantation of central venous portal systems in the forearm. Rofo 169:189–194

    PubMed  CAS  Google Scholar 

  34. Lenhart M, Schatzler S, Manke C, Strotzer M, Seitz J, Gmeinwieser J, Volk M, Zorger N, Feuerbach S, Herold T, Paetzel C (2010) Radiological placement of peripheral central venous access ports at the forearm. Technical results and long term outcome in 391 patients. Rofo 182:20–28

    PubMed  CAS  Google Scholar 

  35. Lersch C, Eckel F, Sader R, Paschalidis M, Zeilhofer F, Schulte-Frohlinde E, Theiss W (1999) Initial experience with Healthport miniMax and other peripheral arm ports in patients with advanced gastrointestinal malignancy. Oncology 57:269–275

    Article  PubMed  CAS  Google Scholar 

  36. Marcy PY, Chamorey E, Amoretti N, Benezery K, Bensadoun RJ, Bozec A, Poissonnet G, Dassonville O, Rame M, Italiano A, Peyrade F, Brenac F, Gallard JC (2008) A comparison between distal and proximal port device insertion in head and neck cancer. Eur J Surg Oncol 34:1262–1269

    PubMed  Google Scholar 

  37. Marcy PY, Magne N, Castadot P, Italiano A, Amoretti N, Bailet C, Bentolila F, Gallard JC (2007) Is radiologic placement of an arm port mandatory in oncology patients?: analysis of a large bi-institutional experience. Cancer 110:2331–2338

    Article  PubMed  Google Scholar 

  38. McNulty NJ, Perrich KD, Silas AM, Linville RM, Forauer AR (2010) Implantable subcutaneous venous access devices: is port fixation necessary? A review of 534 cases. Cardiovasc Interv Radiol 33:751–755

    Article  Google Scholar 

  39. Niederhuber JE, Ensminger W, Gyves JW, Liepman M, Doan K, Cozzi E (1982) Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 92:706–712

    PubMed  CAS  Google Scholar 

  40. Nishinari K, Wolosker N, Bernardi CV, Yazbek G (2010) Totally implantable ports connected to valved catheters for chemotherapy: experience from 350 Groshong devices. J Vasc Access 11:17–22

    PubMed  Google Scholar 

  41. Ozdemir NY, Abali H, Oksuzoglu B, Budakoglu B, Akmangit I, Zengin N (2009) It appears to be safe to start chemotherapy on the day of implantation through subcutaneous venous port catheters in inpatient setting. Support Care Cancer 17:399–403

    Article  PubMed  Google Scholar 

  42. Pardo I, Rager EL, Bowling MW, Fajardo A, Clare S, Goulet R Jr (2011) Central venous port placement: a comparison of axillary versus anterior chest wall placement. Ann Surg Oncol 18:468–471

    Article  PubMed  Google Scholar 

  43. Platzbecker U, Illmer T, Schaich M, Freiberg-Richter J, Helwig A, Plettig R, Jenke A, Ehninger G, Bornhauser M (2001) Double lumen port access in patients receiving allogeneic blood stem cell transplantation. Bone Marrow Transplant 28:1067–1072

    Article  PubMed  CAS  Google Scholar 

  44. Ponnet G, Goossens P, Oost C (1997) A comparative study between 3 venous access systems with various types of catheters. Oncologica 14:18–21

    PubMed  CAS  Google Scholar 

  45. Poorter RL, Lauw FN, Bemelman WA, Bakker PJ, Taat CW, Veenhof CH (1996) Complications of an implantable venous access device (Port-a-Cath) during intermittent continuous infusion of chemotherapy. Eur J Cancer 32A:2262–2266

    Article  PubMed  CAS  Google Scholar 

  46. Puig-La Calle J Jr, Lopez SS, Piedrafita SE, Allende HL, Artigas RV, Puig la CJ (1996) Totally implanted device for long-term intravenous chemotherapy: experience in 123 adult patients with solid neoplasms. J Surg Oncol 62:273–278

    Article  PubMed  Google Scholar 

  47. Ramirez JM, Miguelena JM, Guemes A, Moncada E, Cabezali R, Sousa R (1993) Fully implantable venous access systems. Br J Surg 80:347–348

    Article  PubMed  CAS  Google Scholar 

  48. Rubenstein EB, Fender A, Rolston KV, Elting LS, Prasco P, Palmer J, Road I, Pollock RE, Frisbee-Hume S, Laurence D (1995) Vascular access by physician assistants: evaluation of an implantable peripheral port system in cancer patients. J Clin Oncol 13:1513–1519

    PubMed  CAS  Google Scholar 

  49. Schutz JC, Patel AA, Clark TW, Solomon JA, Freiman DB, Tuite CM, Mondschein JI, Soulen MC, Shlansky-Goldberg RD, Stavropoulos SW, Kwak A, Chittams JL, Trerotola SO (2004) Relationship between chest port catheter tip position and port malfunction after interventional radiologic placement. J Vasc Interv Radiol 15:581–587

    PubMed  Google Scholar 

  50. Sehirali S, Inal MM, Ozsezgin S, Sanci M, Atli O, Nayki C, Yildirim Y, Tinar S (2005) A randomized prospective study of comparison of reservoir ports versus conventional vascular access in advanced-stage ovarian carcinoma cases treated with chemotherapy. Int J Gynecol Cancer 15:228–232

    Article  PubMed  CAS  Google Scholar 

  51. Shetty PC, Mody MK, Kastan DJ, Sharma RP, Burke MW, Venugopal C, Burke TH (1997) Outcome of 350 implanted chest ports placed by interventional radiologists. J Vasc Interv Radiol 8:991–995

    Article  PubMed  CAS  Google Scholar 

  52. Silberzweig JE, Sacks D, Khorsandi AS, Bakal CW (2000) Reporting standards for central venous access. Technology assessment committee. J Vasc Interv Radiol 11:391–400

    Article  PubMed  CAS  Google Scholar 

  53. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73:712–716

    Article  PubMed  Google Scholar 

  54. Sonobe M, Chen F, Fujinaga T, Sato K, Shoji T, Sakai H, Miyahara R, Bando T, Okubo K, Hirata T, Date H (2009) Use of totally implantable central venous access port via the basilic vein in patients with thoracic malignancies. Int J Clin Oncol 14:208–212

    Article  PubMed  Google Scholar 

  55. Stevens B, Barton SE, Brechbill M, Moenter S, Piel AL, Shankle D (2000) A randomized, prospecive trial of conventional vascular ports vs.the vortex "clear-flow" reservoir port in adult oncology patients. JVAD 5(4):37–40

    Google Scholar 

  56. Surov A, Jordan K, Buerke M, Arnold D, John E, Spielmann RP, Behrmann C (2008) Port catheter insufficiency: incidence and clinical-radiological correlations. Onkologie 31:455–461

    Article  PubMed  Google Scholar 

  57. Teichgraber UK, Streitparth F, Cho CH, Benter T, Gebauer B (2009) A comparison of clinical outcomes with regular- and low-profile totally implanted central venous port systems. Cardiovasc Interv Radiol 32:975–979

    Article  Google Scholar 

  58. Vandoni RE, Guerra A, Sanna P, Bogen M, Cavalli F, Gertsch P (2009) Randomised comparison of complications from three different permanent central venous access systems. Swiss Med Wkly 139:313–316

    PubMed  Google Scholar 

  59. Vlasveld LT, Rodenhuis S, Rutgers EJ, Dubbelman AC, Hilton AM, Batchelor D, Rankin EM (1994) Catheter-related complications in 52 patients treated with continuous infusion of low dose recombinant interleukin-2 via an implanted central venous catheter. Eur J Surg Oncol 20:122–129

    PubMed  CAS  Google Scholar 

  60. Wagner HJ, Teichgraber U, Gebauer B, Kalinowski M (2003) Transjugular implantation of venous port catheter systems. Rofo 175:1539–1544

    PubMed  Google Scholar 

  61. Wolosker N, Yazbek G, Nishinari K, Malavolta LC, Munia MA, Langer M, Zerati AE (2004) Totally implantable venous catheters for chemotherapy: experience in 500 patients. São Paulo Med J 122:147–151

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Godelieve Alice Goossens, Marguerite Stas & Martine Jérôme

  2. Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Kapucijnenvoer 35, Box 7001, 3000, Leuven, Belgium

    Godelieve Alice Goossens & Philip Moons

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  1. Godelieve Alice Goossens
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  2. Marguerite Stas
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Correspondence to Godelieve Alice Goossens.

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Goossens, G.A., Stas, M., Jérôme, M. et al. Systematic review: malfunction of totally implantable venous access devices in cancer patients. Support Care Cancer 19, 883–898 (2011). https://doi.org/10.1007/s00520-011-1171-3

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