Complications and management strategies of totally implantable venous access port insertion through percutaneous subclavian vein

Velioğlu, Yusuf; Yüksel, Ahmet; Sınmaz, Emrah

doi:10.5606/tgkdc.dergisi.2019.17972

Cited by 22 publications

(24 citation statements)

References 35 publications

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“…Previous long-term observations studies had reported that the complication-related removal rate accounted or between 1% and 8.3%. [ 15 , 22 , 23 ] The reasons for removal or repositioning of TIVAPs are summarized in Table 3.…”

Section: Discussionmentioning

confidence: 99%

Management of outpatient with totally implantable venous access Ports during the COVID-19 epidemic

Yan¹,

Chao-ya²,

Luo³

et al. 2021

Medicine

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The purpose of this study was to explore the management experience of outpatient with totally implantable central venous access Ports (TIVAPs, Ports) during the epidemic, including whether the extension of the irrigation interval will affect the incidence of catheter occlusion, the reasons for the port removal rate, and the corresponding protective treatment strategies during the COVID-19 epidemic. We retrospectively analyzed the Ports evaluation and flushing procedure data between February 3, 2020 and April 3, 2020; the cases were divided into the normal group and delayed group according to the critical point of the maintenance interval of 28 days (4 weeks). We compared the incidence of catheter obstruction between the 2 groups, analyzed the causes of catheter removal events in the 2 groups, and proposed corresponding protective treatment recommendations. During the period, 329 cases were included in the study. There was no significant difference in the incidence of catheter obstruction between the 2 groups. There were 15 patients with catheter removal, 8 cases of infection, 5 cases of catheter obstruction, and 1 case of an ectopic catheter, as well as 1 case of an overturned port. During the epidemic, no hospital infections related to the Ports flushing procedure occurred. The interval of Ports flushing procedures for patients without clinical symptoms can be appropriately extended during the COVID-19 epidemic. However, once the local infection symptoms or other sources of discomfort appear, Ports assessment needs to be performed as soon as possible. Take enhanced protected and isolation measures did not increase cross-infection during outpatient's flushing procedure at non-COVID-19-designated diagnosis and treatment hospitals.

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Section: Discussionmentioning

confidence: 99%

Management of outpatient with totally implantable venous access Ports during the COVID-19 epidemic

Yan¹,

Chao-ya²,

Luo³

et al. 2021

Medicine

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“…One study analyzed 9346 patients who received TIAP from 2007 to 2016; of the 79 patients who underwent catheterization from the left side, the catheter tip strayed into AV in 7 (0.7%), while the incidence of left catheterization was 8.9% 5 . In 2084 operations involving catheterization via SV, catheter malpositioning was the second most common early complication 6 . A total of 350 TIAP insertions were performed in our inpatient department from January 2019 to June 2019, of which 25 cases (8.0%) involved left vascular access; the catheter migrated to AV in 1 case and to ITV in another, for a total incidence rate of 0.5%.…”

Section: Discussionmentioning

confidence: 99%

“…5 In 2084 operations involving catheterization via SV, catheter malpositioning was the second most common early complication. 6 A total of 350 TIAP insertions were performed in our inpatient department from January 2019 to June 2019, of which 25 cases (8.0%) involved left vascular access; the catheter migrated to AV in 1 case and to ITV in another, for a total incidence rate of 0.5%. The 2 types of allotopia (immediate or postoperative spontaneous) differ in their causes.…”

Section: Discussionmentioning

confidence: 99%

Catheter allotopia with totally implantable access port: A report of three cases and literature review

Wei

et al. 2020

Clinical Case Reports

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Catheter allotopia is a common complication associated with totally implantable access ports (TIAPs) that can lead to premature catheter removal or other secondary risks. Timely detection and treatment are critical to achieving a satisfactory outcome. Totally implantable access ports are safe, efficient, lowrisk, and easy-to-maintain medical devices that provide reliable venous access in patients receiving long-term intravenous infusion. They were first used in cancer therapy in 1982. 1 There are some not insignificant immediate and longterm complications associated with TIAPs including catheter allotopia, pneumothorax, arrhythmia, catheter embolism and infection, and pinch-off syndrome. Catheter allotopia is a common reason for premature catheter removal. Here, we report 3 clinical cases of catheter allotopia in which the TIAP catheter migrated to the azygos vein (AV, Case 1), internal thoracic vein (ITV, Case 2), and lower craniocerebral segment of the right internal jugular vein (IJV, Case 3). We also discuss this issue in the context of the literature. 2 | CASE REPORTS 2.1 | Case 1 A 58-year-old woman was diagnosed with ovarian cancer with peritoneal metastasis. We planned to use the docetaxel plus cisplatin regimen for chemotherapy after she underwent ovarian cancer reduction surgery. Since ultrasonic examination revealed that the patient's right IJV was too thin for catheter insertion, left vascular access was selected and the port was subcutaneously implanted in the left infraclavicular

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“…Major issues related to intravenous port implantation include first attempt success rate [ 1 , 2 , 3 ] and peri-operative and late complications [ 4 , 5 , 6 , 7 ]. Several native vessels can be used as the entry vessel for chest port insertion, including the cephalic vein [ 2 , 3 ], deltoid branch of the thoracoacromial vein [ 8 ], the axillary vein [ 1 , 9 ], the internal jugular vein [ 3 ], the external jugular vein [ 2 ], the left brachiocephalic vein [ 10 , 11 ], and the subclavian vein [ 12 , 13 , 14 ]. However, different implantation methods are used for different target vessels and varying long-term results have been reported.…”

Section: Introductionmentioning

confidence: 99%

“…Third, completely avoid subclavian vein and lower neck IJV puncture. This eliminates iatrogenic arterial puncture [ 13 , 14 ], hemothorax [ 17 ], and mediastinal hematoma [ 18 ]. In addition, pneumothorax [ 13 , 14 ] and catheter fracture related to pinch-off syndrome [ 19 ] are completely avoided.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

Wen

et al. 2021

JPM

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Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

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Complications and management strategies of totally implantable venous access port insertion through percutaneous subclavian vein

Cited by 22 publications

References 35 publications

Management of outpatient with totally implantable venous access Ports during the COVID-19 epidemic

Management of outpatient with totally implantable venous access Ports during the COVID-19 epidemic

Catheter allotopia with totally implantable access port: A report of three cases and literature review

Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

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