Cateteres venosos totalmente implantáveis: histórico, técnica de implante e complicações

Zerati, Antônio Eduardo; Wolosker, Nelson; Luccia, Nélson De; Puech-Leão, Pedro

doi:10.1590/1677-5449.008216

Cited by 48 publications

(51 citation statements)

References 38 publications

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“…14 Recent literatures have shown shifting of standard of care when performing a central venous catheter (CVC) from landmark and surgical based approach toward US guidance. 15 Using ultrasound (US) guidance increases first-pass success and decreases complication rates. 3 Authors have reported complications like arterial puncture, brachial plexus injuries, deep venous thrombosis, and pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

“…20 Supplementary studies have found using the subclavian vein in the Seldinger technique there is a higher risk of catheter-related complications. 15 In other techniques due to repeated puncture of the vein it may cause endothelial injury thus causing thrombus formation. The advantage of our technique is that it decreases the risk for thrombus formation secondary to endothelial tissue damage during the procedure as there is minimal injury to the endothelium.…”

Section: Discussionmentioning

confidence: 99%

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Combined approach for port-a-cath implantation -a dependable alternative

Rai

Kumara

Bishnoi

et al. 2020

Sri Lankan J Anaesthesiol

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Background: Port-a-Cath are routinely warranted as a universal venous access for chemotherapy, due to their operational ease, comparatively less complications and relative ease of maintenance. Catheter implantation can be done either by surgical approach by vein cut-down technique or ultrasound-guided percutaneous technique or by landmark technique using fluoroscopy. Here we present our data on our novel technique. Methods: A descriptive cross-sectional study of 92 consecutive patients who underwent Port-a-Cath implantation for adjuvant therapy, from August 2017 through to July 2019 was done. The procedure was carried out in the minor operation theatre under local anaesthesia with anaesthetist doing a transthoracic echocardiography and surgeon doing a cephalic vein cut down under echocardiography guidance, as a day care procedure. This allowed the catheter to reach the superior vena cava smoothly thus avoiding inadvertent cannulation of the internal jugular vein. Results: Four (4.34%) of 92 patients required additional sedation. No patients required to be reexplored in lieu of erroneous placement of the catheter. In all patients the catheter was placed properly in the superior vena cava-right atrial junction. Late complications amounted to 8.69% of the study group, this included flip over, puncture site infection and catheter blockage. All patients were followed-up for a period of 1 to 6 months. Conclusions: We advocate a combined approach of echocardiography guided Port-a-Cath insertion through cephalic vein cut down as a simple, safe, with satisfactory success rate. It offers a suitable alternative to the other invasive procedures performed under image guidance and avoids radiation exposure and malposition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Combined approach for port-a-cath implantation -a dependable alternative

Rai

Kumara

Bishnoi

et al. 2020

Sri Lankan J Anaesthesiol

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“…2,7,8 This improvement may result from a better port catheter technology which affords more resistance to shearing and higher pressure infusion. 9 Modern TIVD consists of an injection port and a radiopaque silicone or polyurethane catheter.…”

Section: Discussionmentioning

confidence: 99%

Fracture of the Port Catheter and Migration Into the Coronary Sinus: Case Report and Brief Review of the Literature

Lukito

Pranata

Huang

et al. 2019

Clin Med Insights Case Rep

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Introduction: Totally implantable venous device has a good safety profile, although certain complications may occur. Late mechanical complications include catheter fracture and cardiac migration which are rarely occurring in approximately 0.1% to 1% of patients. Case presentation: A 33-year-old woman referred by the surgical oncologist for port catheter fragment extraction through endovascular approach. She was asymptomatic on presentation and has a history of hypertension and smoking. Chest X-ray showed a port catheter fragment previously thought to be in the right atrium at the level of 8-9 thoracic vertebrae (right heart catheterization showed that the port catheter fragment was in the coronary sinus). Angiography of the right outflow tract indicates that the fragment was not in the outflow tract or pulmonary arteries but posterior to it. It was concluded that the port catheter fragment had migrated deep into the coronary sinus and the snare was unable to pull the fragment. It was deemed unfeasible to remove the fragment through the endovascular approach. Discussion: The port catheter fracture had migrated entirely into the coronary sinus and to the deep of our knowledge; this was the fourth case reported in the current literature. We tried to do a review of previous similar case reports; interestingly, this was the only case where the fragmented catheter was situated deep within the coronary sinus without any part of the fragment projected to the right atrium. This made the retrieval of the fragment much more difficult with a high chance of failure. Conclusions: Migration of totally implantable venous device into coronary sinus is a rare but possible complication and might be difficult to remove if the position is unfavorable.

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“…Dessa forma, é preciso optar por recursos que viabilizem um acesso venoso seguro, de longo prazo, o que pode ser obtido por meio do uso do Cateter Venoso Central Totalmente Implantado (CVC-TI), no qual possibilita a infusão prolongada de agentes antineoplásicos, com taxas de infecção menor, devido à redução de sua manipulação, reduz também o incômodo de múltiplas punções periféricas e não restringe as atividades dos pacientes, visto que é pequeno, fica alojado geralmente em locais que a vestimenta cobre o local (4) .…”

Section: Introductionunclassified

Caracterização Do Manuseio Do Cateter Venoso Central Totalmente Implantado Em Uma Unidade Ambulatorial Quimioterápica De Um Hospital Universitário

Rodrigues

Monteles

Gomes

2021

Rev. Enferm. Atual In Derme

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Objetivo: Identificar a frequência e características no manejo e manutenção do cateter totalmente implantado em pacientes oncológicos. Metodologia: Trata-se de um estudo transversal, descritivo, de abordagem quantitativa. O estudo foi realizado na cidade de Fortaleza – CE, no ambulatório oncohematológico de administração de quimioterápicos e sintomáticos, pertencente a um hospital universitário. A coleta ocorreu entre os meses de outubro a novembro de 2020, realizada através das fichas de acompanhamento de pacientes que possuem o dispositivo da própria instituição. Os dados foram armazenados no programa Excel e efetuada a análise quantitativa com demonstração de frequência e percentual. O estudo seguiu os princípios éticos da pesquisa envolvendo seres humanos, resolução nº 466/2012, do Conselho Nacional de Saúde, o projeto foi submetido ao Comitê de Ética em Pesquisa da instituição, obtendo parecer favorável. Resultados: A amostra foi constituída por 55 pacientes, destes 65,5% do sexo feminino, 74,5% possuíam diagnostico de doença hematológica, 45% encontrava-se em acompanhamento no setor de 1 a 5 anos. Foram puncionados o cateter 959 vezes, sendo 49,4% puncionados para administração de quimioterápicos e 48,4% para manutenção do dispositivo, os demais foram para antibioticoterapia e coleta de hemocultura. Ao realizar a aspiração do dispositivo, obteve retorno sanguíneo em 768 vezes, em 86 vezes o sangue refluiu com dificuldade e em 105 ocasiões não obteve retorno sanguíneo. Na grande maioria, 959 ocasiões, utilizou-se como forma de “locking” solução heparinizada Conclusão: Os resultados apresentados evidenciam a complexidade da assistência de enfermagem relacionada ao manuseio do cateter totalmente implantado

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Cateteres venosos totalmente implantáveis: histórico, técnica de implante e complicações

Cited by 48 publications

References 38 publications

Combined approach for port-a-cath implantation -a dependable alternative

Combined approach for port-a-cath implantation -a dependable alternative

Fracture of the Port Catheter and Migration Into the Coronary Sinus: Case Report and Brief Review of the Literature

Caracterização Do Manuseio Do Cateter Venoso Central Totalmente Implantado Em Uma Unidade Ambulatorial Quimioterápica De Um Hospital Universitário

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