A Comparison of Hickman Line- and Port-a-Cath-associated Complications in Patients with Solid Tumours Undergoing Chemotherapy

Ng, Flora; Mastoroudes, Heleni; Paul, E.; Davies, NJ; Tibballs, Jonathan; Hochhauser, Daniel; Mayer, Allan R.; Begent, R. H. J.; Meyer, Travis E

doi:10.1016/j.clon.2007.04.003

Cited by 71 publications

(54 citation statements)

References 11 publications

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“…The reported event rate ranged from 0.45 to 1.16 events/1,000 port days [5,6,7,8,9,10,11]. Our study showed comparable results with 0.96 overall events/1,000 port days.…”

Section: Discussionsupporting

confidence: 78%

“…Totally implantable venous access devices have proved to be less susceptible to complications than tunneled catheter systems [10, 12, 13]. The reported event rate ranged from 0.45 to 1.16 events/1,000 port days [5,6,7,8,9,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Different studies have evaluated the usefulness and reliability of totally implantable catheter devices with particular interest for the most common complications occurring during or after implantation [5,6,7,8,9,10,11]. As a measure of quality control at our center, we performed a retrospective analysis to identify complications in our patients with implanted port systems.…”

Section: Introductionmentioning

confidence: 99%

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Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Samaras¹,

Dold²,

Braun

et al. 2008

Oncology

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Background: We assessed longevity and complications of totally implantable venous access devices in oncology patients. Methods: 197 patients received a total of 201 port devices via the subclavian vein for delivery of chemotherapy between January 1, 2005, and December 31, 2006. We reviewed the patient charts for port-related complications and risk factors until July 31, 2007. Results:A total of 47,781 catheter days were analyzed (median, 175 days; range, 1–831). Forty-six different complications occurred (0.96 complications/1,000 catheter days). The only risk factor significantly associated with a higher complication rate was younger age. Older patients had a lower risk for developing complications with a risk reduction of 2.4% for each year. There were no differences regarding underlying tumor, gender, access side, method of placement (subclavian/cephalic vein) or implanting team (thoracic versus visceral surgery). A trend was seen for shorter port longevity in hematologic patients compared to oncologic patients (p = 0.059). The former developed significantly more port-associated infections than solid tumor patients [11/53 cases (21%) versus 2/148 cases (1.4%); p < 0.0001]. Conclusions: Port-associated infections were mostly observed in younger patients with hematologic neoplasms. Prospective trials should be performed to evaluate the benefit of a prophylactic antimicrobial lock in these selected patients.

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“…The reported event rate ranged from 0.45 to 1.16 events/1,000 port days [5,6,7,8,9,10,11]. Our study showed comparable results with 0.96 overall events/1,000 port days.…”

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Samaras¹,

Dold²,

Braun

et al. 2008

Oncology

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“…PICCline indications include continuous venous access (bone marrow transplantation), patients with acute leukaemia and/or at high risk of haemorrhage [54], daily access, patients needing dialysis and needle-phobic patients, whereas venous port indications include long-term and intermittent infusion therapy (weeks to months). Ports have great advantages over PICCs, such as safety, low infection rates, patient comfort and cost effectiveness after a few weeks [55].…”

Section: Indications For Long-line Insertionmentioning

confidence: 99%

Central venous access: techniques and indications in oncology

Marcy

2008

Eur Radiol

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Long lines can be inserted centrally or peripherally through patent veins into the central venous system down to the atrial caval junction. Traditionally surgeons, anesthetists, cardiologists and more recently interventional radiologists have been placing them using vein cutdown or percutaneous needle puncture techniques. Typical candidates for implanted venous catheters are cancer patients undergoing long-term chemotherapy. The most important issues, in addition to the patency of central veins and the history of previous indwelling catheters, pacewires or venous thrombosis, are the patient's performance status, body mass index, medical history and respiratory status, and the relevant technique. The present article will give an overview of the radiological and surgical implantation techniques and will highlight the impact of imaging means on the technical feasibility, assessment and treatment of device-related complications.

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“…The procedure is usually performed under sedation or general anesthetic. As the breach of skin integrity does not exceed the caliber of the needle, the risk of infection and thrombosis is lower compared to indwelling catheters such as Hickman catheters [1]. Many studies have analyzed the complications associated with implantable catheters, however very few have commented on the ideal or recommended length of the maintenance period between flushing the port with heparin [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Extending the interval for port-a-cath maintenance

Girda¹,

Phaëton²,

Goldberg³

et al. 2013

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Objective: The objective of this study is to assess the outcome of port-a-cath (PAC) maintenance every three months in patients with gynecologic malignancies with the goal of standardizing a safe and appropriate interval that would maintain patency and minimize side effects. Methods: We performed a retrospective medical record review and evaluation of all patients with a Bard © PAC who were noted to have no evidence of disease (NED) during the years 2003 to 2010. The interval between accessions and any complications related to the presence of the PAC were recorded. Relevant complications included skin infections, bacteremia, thrombosis, and occlusions. Statistical analysis was done using the Fisher's exact test. Results: A total of 201 patients had PAC placed and 43 patients underwent PAC accessions to maintain patency. The total number of accessions was 150 with a median number per patient of 2.0 (range 1 -10). The mean time between flushes was 112 days (SD = 57). When comparing women in maintenance who had flushes within 90 days versus those who had flushes over 90 days apart, there was no difference in infection or occlusion rates between these groups (p = 0.515). In the <90-day group, one patient was noted to have resistance during the flush. In the ≥90-day group, one patient had an occlusion that did not resolve with Alteplase. Another patient had skin erythema with spontaneous resolution. Conclusion: Infections and occlusions are rare in women with gynecologic malignancies undergoing maintenance of their PAC. Longer intervals between PAC flushes do not appear to affect the outcome in our patients. Our ongoing data and follow-up confirm that extending the interval of PAC accession to every 3 months, rather than monthly, is safe, effective and convenient in the patient population with gynecologic malignancies.

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A Comparison of Hickman Line- and Port-a-Cath-associated Complications in Patients with Solid Tumours Undergoing Chemotherapy

Cited by 71 publications

References 11 publications

Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Infectious Port Complications Are More Frequent in Younger Patients with Hematologic Malignancies than in Solid Tumor Patients

Central venous access: techniques and indications in oncology

Extending the interval for port-a-cath maintenance

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