Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan

Shiono, Masatoshi; Takahashi, Shin; Takahashi, Masanobu; Yamaguchi, Takuhiro; Ishioka, Chikashi

doi:10.1007/s10147-016-1003-z

Cited by 22 publications

(19 citation statements)

References 38 publications

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“…A national Japanese survey by Shiono et al 7 showed an overall incidence of complication rates of 7.3% and 5.2% in forearm and arm implanted ports, respectively. The majority of reported complications in these studies were infections and venous thromboses.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 As is the case with breast cancer patients, arm ports in patients who have head and neck tumours and a tracheostomy can potentially reduce infections since the access site in these latter patients is far from tracheal secretions that might facilitate cutaneous bacterial overgrowth increasing the risk of TIVAD pocket infections. [5][6][7][8] Despite these advantages, there are some concerns about a higher incidence of complications in patients with arm port devices as compared to chest ports. 2 Catheter occlusion, upper extremity deep vein thrombosis (UEDVT), skin dehiscence and needle dislocation with drug extravasation are reportedly responsible for the removal of the device in 4%-17% of patients.…”

Section: Introductionmentioning

confidence: 99%

“…2 Catheter occlusion, upper extremity deep vein thrombosis (UEDVT), skin dehiscence and needle dislocation with drug extravasation are reportedly responsible for the removal of the device in 4%-17% of patients. [6][7][8] In order to evaluate the possibility of reducing the incidence of arm TIVAD failures, the authors introduced a technical variation to the standard method of arm port placement named the peripherally inserted central catheter (PICC)-PORT technique. It consists of a percutaneous venous access through the basilic or brachial veins, which is always performed under ultrasound guidance using the micro-Seldinger technique that allows the venous catheter to be inserted in the proximal third of the upper arm, close to the axilla.…”

Section: Introductionmentioning

confidence: 99%

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PICC-PORT totally implantable vascular access device in breast cancer patients undergoing chemotherapy

et al. 2019

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Background and objectives: The increasing use of arm totally implantable vascular access devices for breast cancer patients who require chemotherapy has led to a greater risk of complications and failures and, in particular, to upper extremity deep vein thrombosis. This study aims to investigate the outcomes of the arm peripherally inserted central catheter-PORT technique in breast cancer patients. Methods: The peripherally inserted central catheter-PORT technique is an evolution of the standard arm-totally implantable vascular access device implant based on guided ultrasound venous access in the proximal third of the upper limb with subsequent placement of the reservoir at the middle third of the arm. A prospective study was conducted on 418 adult female breast cancer patients undergoing chemotherapy. The primary study outcome was peripherally inserted central catheter-PORT failure. Results: Median follow-up was 215 days. Complications occurred in 29 patients (6.9%) and failure resulting in removal of the device in 11 patients (2.6%). The main complication we observed was upper extremity deep vein thrombosis, 10 (2.4%); all patients were rescued by anticoagulant treatment without peripherally inserted central catheter-PORT removal. The main reason for removal was reservoir pocket infection: 4 (0.9%) with an infection rate of 0.012 per 1000 catheter days. Cumulative 1-year risk of failure was 3.6% (95% confidence interval, 1.3%–7.1%). With regard to the patients’ characteristics, body mass index <22.5 was the only significant risk for failure ( p = 0.027). Conclusion: The peripherally inserted central catheter-PORT is a safe vascular device for chemotherapy delivery that achieves similar clinical results as traditional long-term vascular access devices (peripherally inserted central catheter and arm totally implantable vascular access device, in particular) in breast cancer patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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PICC-PORT totally implantable vascular access device in breast cancer patients undergoing chemotherapy

et al. 2019

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“…A randomized controlled study has confirmed that there are no differences in the incidence of catheter-related thrombotic events or catheter blockage between left-side and right-side port implantation[ 22 ]. Percutaneous puncture methods include blind puncture based on anatomical landmarks, real-time ultrasound guidance and venography, and the ultrasound-guided real-time method, which is currently the most common[ 23 ]. Research has shown that ultrasound real-time guidance can improve puncture efficiency and reduce venous catheter-related infections[ 24 ].…”

Section: Clinical Questionsmentioning

confidence: 99%

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

Zhang

Chen

2020

WJG

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Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time. Advantages of ports include a simple nursing process, low risk of infection and embolism, and high patient comfort. In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications, the Chinese Research Hospital Association Digestive Tumor Committee, the Chinese Association of Upper Gastrointestinal Surgeons, the Chinese Gastric Cancer Association, and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nation-wide expert letter reviews and on-site seminars, and formulated an expert consensus of the operation guidelines.

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“…In 1993, an alternative arm port procedure was introduced by surgeons at the School of Medicine, Yale University 7. The arm ports have some unique advantages compared with chest ports, such as no risk for hemothorax or pneumothorax, lower incidence of arterial puncture,8 better cosmetic outcome,9 and more “bra convenience” 10. These advantages are especially beneficial to breast cancer patients requiring radiotherapy, flap transferring for reconstructive surgeries, as well as those patients with radiodermatitis or compromised respiratory function 11.…”

Section: Introductionmentioning

confidence: 99%

<p>Arm port vs chest port: a systematic review and meta-analysis</p>

Li¹,

Ma²,

Zheng³

2019

CMAR

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Background Two prevailing, totally implantable venous access ports are routinely utilized in oncology: chest port or arm port. This systematic review with meta-analysis was conducted to compare safety and efficiency of the two techniques. Methods We performed evidence acquisition intensively from PubMed, Embase, and Cochrane Library. Available comparative studies that evaluated both techniques were identified. The outcomes of interest included total complication events, procedure-related infections, thrombosis, intra-operative complications, mechanical complications, conversion rate, early port removal, and operating time. Results Thirteen comparative studies including 3,896 patients (2,176 for chest ports, and 1,720 for arm ports) were identified. The present study showed that arm port was associated with higher procedure conversion rate (2.51% in chest port group and 8.32% in arm port group; odd ratios [OR] 0.27, 95% confidence interval [CI] 0.15-0.46; p <0.001), but lower incidence of intra-operative complications (1.38% in chest port group and 0.41% in arm port group; OR 2.38, 95% CI 1.07–5.29; p =0.03). There were no between-group differences with respect to total complication events, procedure-related infections, thrombosis, mechanical complications, early port removal, and operating time. Subgroup analysis of patients under 60 years revealed that no significant difference was detected in intra-operative events (1.19% in chest port group and 0.02% in arm port group, OR 2.59, 95% CI 0.74–9.08; p <0.14), indicating that age may be a risk factor for intra-operative events. Sensitivity analysis did not change conclusions of all endpoints of interest. Conclusion Arm port is associated with higher procedure conversion rate, but lower incidence of intra-operative complications, and age may be a risk factor for intra-operative events.

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Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan

Abstract: Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

Cited by 22 publications

References 38 publications

PICC-PORT totally implantable vascular access device in breast cancer patients undergoing chemotherapy

PICC-PORT totally implantable vascular access device in breast cancer patients undergoing chemotherapy

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

<p>Arm port vs chest port: a systematic review and meta-analysis</p>

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