A comparison of placement techniques and complications of externalized catheters and implantable port use in children with cancer

Mirro, Joseph; Rao, Bhaskar N.; Kumar, Mahesh; Rafferty, Mary Ellen; Hancock, Michael L.; Austin, Bradford A.; Fairclough, Diane; Lobe, Thom E.

doi:10.1016/s0022-3468(05)80176-9

Cited by 83 publications

(35 citation statements)

References 19 publications

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“…One pediatric study observed CVL failure-that is, loss of patency-to be less likely with percutaneous CVL than with surgically inserted CVL. 21 Loss of CVL patency, however, does not necessarily correlate with large vessel thrombosis. In contrast, a recent study in adults observed an increased frequency of VTE with CVL inserted by radiologists-that is, percutaneously-than with CVL inserted by surgical cut-down.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have provided data on the association between CVL body side, 8,[10][11][12][13][14][15] CVL vein location, 14,[16][17][18][19][20] or CVL insertion technique 15,21 with the incidence of VTE. Results from these studies are inconsistent or even contradictory, probably because of differences in study design, selection of study populations, and outcome assessment.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Male

Chait

Andrew

et al. 2003

Blood

224

164

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Venous thromboembolic events (VTEs) in children are associated with central venous lines (CVLs). The study objective was to assess whether CVL location and insertion technique are associated with the incidence of VTE in children. We hypothesized that VTE would be more frequent with (1) CVL location on the left body side, (2) CVL location in the subclavian vein rather than the jugular vein, and (3) CVL insertion by percutaneous technique rather than venous cut-down. This was a prospective, multicenter cohort study in children with acute lymphoblastic leukemia who had a CVL placed in the upper venous system during induction chemotherapy. Characteristics of CVL were documented prospectively. All children had outcome assessment for VTE by objective radiographic tests, including bilateral venography, ultrasound, echocardiography, and cranial magnetic resonance imaging. Among 85 children, 29 (34%) had VTE; 28 VTEs appeared in the upper venous system, and 1 was sinovenous thrombosis. Left-sided CVL (odds ratio [OR], 2.5; 95% confidence interval, 1.0-6.4; P ‫؍‬ .048), subclavian CVL (OR, 3.1; 95% CI, 1.2-8.5; P ‫؍‬ .025), and percutaneous CVL insertion (OR, 3.5; 95% CI, 1.3-9.2; P ‫؍‬ .011) were associated with an increased incidence of VTE. Interaction occurred between CVL vein location and insertion technique. Subclavian vein CVL inserted percutaneously had an increased incidence (54%) of VTE compared with any other combination (P ‫؍‬ .07). For CVL in the upper venous system, CVL placement on the right side and in the jugular vein may reduce the risk for CVL-related VTE. If subclavian vein placement is necessary, CVL insertion by venous cutdown appears preferable over percutaneous insertion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Male

Chait

Andrew

et al. 2003

Blood

224

164

View full text Add to dashboard Cite

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“…Since there are no external components, they are less visible and more easily accepted by patients: They cause no restrictions on daily activities; local care is easier; the risk of infection [1][2][3] and thrombosis [4] is lower, they are less costly; and they can be kept in place for longer periods of times. For these reasons, TIVADs have been commonly used in oncological patients, both adults and children.…”

Section: Introductionmentioning

confidence: 99%

Long‐term complications in totally implantable venous access devices: Randomized study comparing subclavian and internal jugular vein puncture

Ribeiro

Abib

Aguiar

et al. 2011

Pediatric Blood & Cancer

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BackgroundThis prospective randomized study evaluated complications related to long‐term totally implantable catheters in oncologic children and adolescents by comparing venopunction performed either in the jugular or subclavian vein.MethodsA total of 83 catheters were implanted from January 2004 to April 2006 and followed‐up until March 2008. Patients were randomly allocated to the subclavian or jugular vein group. The endpoint was complications that led to catheter revision or catheter removal.ResultsSix patients were excluded, 43 had the catheter implanted in the subclavian and 34 in the jugular vein. Subclavian catheters were used for up to 12.6 months, while jugular catheters were kept in place for up to 14.8 months (P = 0.38). No statistical differences were found between the groups concerning age, sex, leukocyte count, platelet count, type of admission (in or outpatient), or previous chemotherapy regimens. When analyzed individually, long‐term complications did not present statistically significant differences either. Infection occurred in 20 and 11% (P = 0.44), while catheter embolism took place in 23 and 8% (P = 0.11) of patients with subclavian and jugular catheters, respectively. A statistical difference was seen in the total number of complications, which occurred in 48 and 23% (P = 0.02) of patients in the subclavian and in the jugular groups, respectively.ConclusionsCatheters implanted by puncture in the subclavian vein were more prone to late complications than those implanted in the jugular vein. Pediatr Blood Cancer 2012; 58: 274–277. © 2011 Wiley Periodicals, Inc.

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“…Since some data suggest that they have a higher complication rate compared to indwelling catheters in patients with hematological malignancies, 12 venous ports have been preferentially used in patients with solid tumors. 13,14 Nevertheless port systems have been shown to provide stable venous access beyond day 100 15 with a rate of infection and thrombosis comparable to external vascular access devices even in patients with leukemia. 2,[16][17][18][19] Ports were shown to provide longer failurefree function than Hickman and Broviac catheters.…”

Section: Discussionmentioning

confidence: 99%

“…2,[16][17][18][19] Ports were shown to provide longer failurefree function than Hickman and Broviac catheters. 15 The feasibility of prolonged and durable central venous access in a dog model of myeloablative BMT has been shown by Dennis et al 20 While there are reports on single lumen ports in patients with leukemia, 21 no data on the prospective use of port devices in patients receiving allogeneic blood stem cell transplantation have been published. In the present study, we have shown the feasibility of using a DLPS in patients undergoing allogeneic SCT.…”

Section: Discussionmentioning

confidence: 99%

Double lumen port access in patients receiving allogeneic blood stem cell transplantation

Platzbecker

Illmer

Schaich

et al. 2001

Bone Marrow Transplant

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Summary:We performed a prospective trial investigating the feasibility of a double lumen port access in 26 patients with hematological malignancies or solid tumors receiving either standard conditioning (n ‫؍‬ 9, median age 49 years (range 19-65)) or dose-reduced conditioning (n ‫؍‬ 17, median age 56 years (range 35-66)) followed by allogeneic blood stem cell transplantation. The port system was implanted within 3 months (n ‫؍‬ 20, range 7-91 days) before transplantation or as indicated at different time points after transplantation (n ‫؍‬ 6, range 28-680 days). Most infusions, including the graft itself and all blood drawings, were performed via the port. Over a cumulative duration of 5622 days (1310 days after standard conditioning (range 56-349) and 4431 days after dose-reduced conditioning (range 49-489)) two port systems of patients receiving standard conditioning were removed due to early postimplantation pocket infection on day 6 and 8 after insertion, respectively. In the dose-reduced conditioning group only one late removal (day 287) of a port was required. Most of the patients in both groups reported less pain and a higher degree of comfort compared to peripheral or central venipuncture. The use of double lumen port access during conditioning and in an outpatient setting after allogeneic hemopoietic stem cell transplantation is feasible and advantageous for both patient and medical staff. Implantation several weeks before the start of conditioning might help in avoiding early infectious complications after conventional myeloablative conditioning. Bone Marrow Transplantation (2001) 28, 1067-1072. Keywords: double lumen port; allogeneic; dose-reduced conditioning Dose-reduced conditioning (DRC) followed by allogeneic stem cell transplantation (SCT) is increasingly performed

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A comparison of placement techniques and complications of externalized catheters and implantable port use in children with cancer

Cited by 83 publications

References 19 publications

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Long‐term complications in totally implantable venous access devices: Randomized study comparing subclavian and internal jugular vein puncture

Double lumen port access in patients receiving allogeneic blood stem cell transplantation

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