Femoral placement of a totally implantable venous access port with spontaneous catheter fracture: case report

Kondo, Tomohiro; Matsumoto, Shigemi; Doi, Kouki; Nomura, Mamoru; Muto, Manabu

doi:10.1186/s42155-019-0094-9

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…This is in line with current experimental evidence from several investigators so far. 12,14,[29][30][31] It is indeed true that polyurethane CVCs showed more geometrical uniformity and much less granularity inside walls, even though the second biggest air bubble was found exactly on this type of material in sample PU1 (ca. 90 µm in diameter, as shown in Figure 6(d)-(f)).…”

Section: Discussionmentioning

confidence: 99%

Comparative structural analysis of polyurethane and silicone catheters of totally implantable venous access devices by micro-computed tomography

et al. 2021

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Objectives: To investigate microstructural alterations of explanted long-term central venous catheters of totally implantable venous access devices, using micro-computed tomography. Methods: A total of 16 catheters (9 made of silicone and 7 made of polyurethane), all non-fractured, have been analyzed in this study. Eight catheters were implanted for an average duration of 994 days (min–max: 98–2731 days), while the remaining eight catheters (four for each material, forming the SIref and PUref control groups) were analyzed before implant and used as a reference. X-ray micro-computed tomography was used to reconstruct the three-dimensional geometry of selected segments of each catheter (ca. 10 cm per sample). Results: Morphometric analysis of the catheters revealed increases wall thickness and section area in the polyurethane group as compared with the reference central venous catheters of the same materials (wall thickness: 403 ± 12 μm in the polyurethane (PU) group vs 382 ± 4 μm in PUref, p = 0.014; wall cross-section area: 2.04 ± 0.09 mm2 in PU vs 1.91 ± 0.03 mm2 in PUref, p = 0.04), whereas implanted silicone catheters showed a larger luminal cross section as compared with their controls (lumen cross-section area = 0.851 ± 0.020 mm2 in silicone (SI) group vs 0.811 ± 0.007 mm2 in SIref, p = 0.007). All analyzed samples in this study presented some type of alteration in the catheter walls, namely, hyperdense spots (below 0.1 mm size), air gaps/bubbles and displacements of inner and outer axes causing heterogeneous wall thickness. The incidence of air gaps showed no difference with respect to both material type and duration of implant, whereas the SI group revealed more hyperdense spots as compared to all other groups. Conclusion: Morphological change and local structural alteration can occur in both silicone and polyurethane catheters. This evidence suggests the need for further studies connecting those morphological changes with modification of mechanical robustness, which ultimately can play a role for patient safety.

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Section: Discussionmentioning

confidence: 99%

Comparative structural analysis of polyurethane and silicone catheters of totally implantable venous access devices by micro-computed tomography

et al. 2021

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“…Despite these various advantages, certain complications that are associated with the implantation procedure or the long-term use of the TIVAP may occur [10]. These complications can be divided into 3 main categories: procedural complications (such as haemothorax, pneumothorax, cardiac arrhythmia, injury of the brachial plexus and catheter malposition), early complications (occurring before the rst chemotherapy application, such as pocket haematoma and brin formation) and late complications (occurring after the rst chemotherapy application, such as thrombosis, infection, "pinch off" syndrome, catheter rupture, embolization, extravasation and catheter migration) [4,[11][12][13]. Among all of these reported complications, catheter migration is rarely seen but is regarded as being a potentially severe condition, which can likely lead to TIVAP replacement or removal.…”

Section: Discussionmentioning

confidence: 99%

Migration of catheter of a totally implantable venous access port to right thoracic cavity in a child - a case report

Ren

et al. 2021

Preprint

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BackgroundThe totally implantable venous access port (TIVAP) is a secure and practical choice for children undergoing long-term chemotherapy. Nevertheless, various complications still need to be treated cautiously. Among the complications, the migration of catheters to the thoracic cavity is a very rare (but potentially severe) condition that may necessitate device reimplantation. Furthermore, this migration may even be life-threatening if it is not detected in time.Case presentationA 1-year-old girl undergoing palliative chemotherapy underwent TIVAP placement via the right internal jugular vein. During the operating procedure, the catheter tip was located in the right atrium, which was confirmed by the use of C-arm. Prophylactic intravenous antibiotics were then adopted with routine aspiration and with flushing being conducted each time before administration. Massive right pleural effusion and migration of the catheter tip to the right thoracic cavity were detected on the 2nd day after implantation, which resulted in the removal and reimplantation of the TIVAP device.ConclusionsThe migration of the catheter into the thoracic cavity should be considered a possible complication of TIVAP implantation in children. Early detection and reimplantation may provide opportunities for the prevention of further severe complications.

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Totally implanted central venous access devices inserted by the femoral route: A narrative review and the proposal of a novel approach, the FICC-port

Annetta,

Marche,

Ortiz Miluy

et al. 2024

J Vasc Access

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Background: Femoral ports are used in patients with indication to a totally implanted venous access device but with contraindication to chest-ports and brachial ports because of obstruction of the superior vena cava. In the last three decades, femoral ports have been implanted almost exclusively by cannulation of the common femoral vein at the groin, while the position of the tip has been assessed by X-ray. Methods: We report our experience with a new approach to femoral ports, which includes recent methods and techniques developed in the last few years. These novel femoral ports, which we call “FICC-ports,” are characterized by (a) long femoral 5 Fr polyurethane catheter inserted by ultrasound-guided puncture of the superficial femoral vein at mid-thigh; (b) intraprocedural location of the tip in the sub-diaphragmatic inferior vena cava, using ultrasound visualization by the transhepatic and/or the subcostal view; (c) low-profile or very low-profile reservoir implanted above the quadriceps muscle, at mid-thigh. Results: In the last 3 years, we have implanted 47 FICC-ports in young adults with mediastinal lymphoma compressing the superior vena cava. We had no immediate/early complication, and only three late complications (one kinking of the catheter in the subcutaneous tissue; one tip migration with secondary venous thrombosis; one persistent withdrawal occlusion due to fibroblastic sleeve). Conclusion: If there is indication to a femoral port, the implantation of a “FICC-port”—as described above—is to be strongly considered in terms of safety, effectiveness, and cost-effectiveness: no immediate-early complications, minimal late complications, no X-ray exposure, low invasiveness, low cost.

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Femoral placement of a totally implantable venous access port with spontaneous catheter fracture: case report

Cited by 3 publications

References 10 publications

Comparative structural analysis of polyurethane and silicone catheters of totally implantable venous access devices by micro-computed tomography

Comparative structural analysis of polyurethane and silicone catheters of totally implantable venous access devices by micro-computed tomography

Migration of catheter of a totally implantable venous access port to right thoracic cavity in a child - a case report

Totally implanted central venous access devices inserted by the femoral route: A narrative review and the proposal of a novel approach, the FICC-port

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