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Complications and pitfalls of central venous port catheters: experience with 782 patients with cancer

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Abstract

Background

The clinical use of port catheters has become widespread because they provide a safe and easy vascular route. Such widespread use of vascular port catheters has revealed early and late complications.

Aim

This study was evaluated the early and late noninfectious complications and present precautions and pitfalls to handle these complications.

Methods

The retrospective observational study comprised 801 vascular port catheters inserted into 782 adult patients for various reasons between 2010 and 2018. Patient demographic, indications for port catheter implantation, port catheter types, and insertion sides were noted. Port catheter implantation related early and late complications were recorded.

Results

The subclavian vein was selected as a target vein in almost all of the interventions (98.9%). Similarly, right-sided veins were used in about 90% of patients. The most common problem was technical issues related to the interventions. If venous cannulation was challenging, ultrasonography and fluoroscopy guidance roadmap technique were used. Most serious complication was pneumothorax in 7 patients. In the late period, the most common problem was thrombotic occlusion of the catheter. In two-thirds of these patients, thrombolytic therapy for thrombosed port catheters may rescue some catheters and avoid secondary port catheter insertions.

Conclusions

Despite these benefits, port catheters are associated with various complications. However, most of these complications can be effectively prevented by proper techniques and easily applied precautions.

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References

  1. 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

    CAS  PubMed  Google Scholar 

  2. Biffi R, Toro A, Pozzi S, Di Carlo I (2014) Totally implantable vascular access devices 30 years after the first procedure. What has changed and what is still unsolved? Support Care Cancer 22:1705–1714

    Article  Google Scholar 

  3. Zaghal A, Khalife M, Mukherji D, El Majzoub N, Shamseddine A, Hoballah J et al (2012) Update on totally implantable venous access devices. Surg Oncol 21:207–215

    Article  Google Scholar 

  4. Ramsay MA, Savege TM, Simpson BR, Goodwin R (1974) Controlled sedation with alphaxalone-alphadolone. Br Med J 2(5920):656–659

    Article  CAS  Google Scholar 

  5. McGee DC, Gould MK (2003) Preventing complications of central venous catheterization. N Engl J Med 348:1123–1133

    Article  Google Scholar 

  6. Mudan S, Giakoustidis A, Morrison D, Iosifidou S, Raobaikady R, Neofytou K et al (2015) 1000 Port-A-Cath (R) placements by subclavian vein approach: single surgeon experience. World J Surg 39:328–334

    Article  CAS  Google Scholar 

  7. Di Carlo I, Pulvirenti E, Mannino M, Toro A (2010) Increased use of percutaneous technique for totally implantable venous access devices. Is it real progress? A 27-year comprehensive review on early complications. Ann Surg Oncol 17:1649–1656

    Article  Google Scholar 

  8. Tabatabaie O, Kasumova GG, Eskander MF, Critchlow JF, Tawa NE, Tseng JF (2017) Totally implantable venous access devices: a review of complications and management strategies. Am J Clin Oncol 40:94–105

    Article  Google Scholar 

  9. Biffi R, Orsi F, Pozzi S, Pace U, Bonomo G, Monfardini L et al (2009) Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial. Ann Oncol 20:935–940

    Article  CAS  Google Scholar 

  10. Yanik F, Karamustafaoglu YA, Karatas A, Yoruk Y (2018) Experience in totally implantable venous port catheter: analysis of 3,000 patients in 12 years. Turk Gogus Kalp Damar Cerrahisi Derg 26:422–428

    Article  Google Scholar 

  11. Barbetakis N, Asteriou C, Kleontas A, Tsilikas C (2011) Totally implantable central venous access ports. analysis of 700 cases. J Surg Oncol 104:654–656

    Article  Google Scholar 

  12. Silberzweig JE, Cooper JM, Podolak MJ, Grossman GD, Patterson JL, Mitty HA (1996) Venography in the lordotic projection to facilitate central venous access. J Vasc Interv Radiol 7:439–440

    Article  CAS  Google Scholar 

  13. Plumhans C, Mahnken AH, Ocklenburg C, Keil S, Behrendt FF, Gunther RW et al (2011) Jugular versus subclavian totally implantable access ports: catheter position, complications and intrainterventional pain perception. Eur J Radiol 79:338–342

    Article  Google Scholar 

  14. Grannan KJ, Taylor PH (1990) Early and late complications of totally implantable venous access devices. J Surg Oncol 44:52–54

    Article  CAS  Google Scholar 

  15. Kim JT, Oh TY, Chang WH, Jeong YK (2012) Clinical review and analysis of complications of totally implantable venous access devices for chemotherapy. Med Oncol 29:1361–1364

    Article  Google Scholar 

  16. Orci LA, Meier RP, Morel P, Staszewicz W, Toso C (2014) Systematic review and meta-analysis of percutaneous subclavian vein puncture versus surgical venous cutdown for the insertion of a totally implantable venous access device. Br J Surg 101:8–16

    Article  CAS  Google Scholar 

  17. Dariushnia SR, Wallace MJ, Siddiqi NH, Towbin RB, Wojak JC, Kundu S, Cardella JF, Society of Interventional Radiology Standards of Practice Committee (2010) Quality improvement guidelines for central venous access. J Vasc Interv Radiol 21:976–981

    Article  Google Scholar 

  18. Muncie C, Herman R, Collier A, Berch B, Blewett C, Sawaya D (2018) Wound complications after chemo-port placement in children: does closure technique matter? J Pediatr Surg 53:572–575

    Article  Google Scholar 

  19. Fish A, Rollins MR, Langley P, King M, Forney C, Josephson CD, Fasano RM (2018) Twiddler's syndrome in an adolescent female with an apheresis port. Transfusion. 58:280–281

    Article  Google Scholar 

  20. Forauer AR, Chen Y, Parks R (2005) A case of posttraumatic Twiddler's syndrome. J Vasc Interv Radiol 16:562–563

    Article  Google Scholar 

  21. Gebarski SS, Gebarski KS (1984) Chemotherapy port "Twiddler's syndrome". A need for preinjection radiography. Cancer. 54:38–39

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Gülhane Training and Research Hospital, 06010, Ankara, Turkey

    Mehmet Emin Ince, Gökhan Ozkan & Nadide Ors

  2. Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey

    Alperen Kutay Yildirim

  3. Department of Cardiovascular Surgery, Gülhane Training and Research Hospital, Ankara, Turkey

    Suat Doganci

Authors
  1. Mehmet Emin Ince
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  2. Gökhan Ozkan
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  3. Nadide Ors
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  4. Alperen Kutay Yildirim
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  5. Suat Doganci
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Correspondence to Mehmet Emin Ince.

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It was obtained from the institutional Local Ethics Committee for the current study. We have read and understood your journal’s policies, and we believe that neither the manuscript nor the study violates any of these.

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There are no conflicts of interest to declare. All authors have participated in the work and could publicly defend its contents, and have read the manuscript prior to its submission for publication and agree with its contents.

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Ince, M.E., Ozkan, G., Ors, N. et al. Complications and pitfalls of central venous port catheters: experience with 782 patients with cancer. Ir J Med Sci 189, 1371–1377 (2020). https://doi.org/10.1007/s11845-020-02207-5

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  • DOI: https://doi.org/10.1007/s11845-020-02207-5

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