Innovative application of an implantable venous access system in the portal vein: technique, results and complications in three dogs

Abstract

Background Vascular access port (VAP) systems are widely used in human medicine to provide long-term venous access. However, in veterinary medicine the use of VAP systems is not common practice and publications on their potential applications have been limited. A VAP system was used as part of an experimental study on liver regeneration and implanted in the canine portal vein to create direct access to the portal venous circulation of the liver. The aim of the present study is to describe the surgical technique, its use, and the complications of a VAP system in three research dogs. Results The VAP system was successfully used for the intraoperative measurement of portal blood pressure, the administration of cell suspensions, and the collection of portal venous blood samples. Long-term complications consisted of dislocation of the VAP system in one dog (2 months after implantation) and thrombus formation at the catheter tip in two dogs (3 months after implantation). Both complications prevented further use of the VAP but had no adverse clinical implications. Conclusions This pilot study suggests that the VAP system is an effective and safe technique to obtain long term access to the portal venous system in dogs. However, complications with port detachment and thrombosis may limit long term use of VAPs in the portal system of dogs.

Long-Term Survival of Transplanted Autologous Canine Liver Organoids in a COMMD1-Deficient Dog Model of Metabolic Liver Disease

“…For human and canine hepatocyte transplantations, administration through the portal vein is an elegant, relatively non-invasive, safe and already clinically applied procedure that allows rapid dispersion over the liver [24,25,29]. Experimental mouse, rat and human liver organoid transplantations in rodents have been performed by intrasplenic injection, which also result in cellular engraftment in the liver via the splenic vein which feeds the portal vein [9,10].…”

“…Using a midline celiotomy approach, a left lateral hepatic lobectomy was performed, resulting in approximately 20% reduction in liver mass. A permanent Port-A-Cath (PAC, Smiths Medical, Rosmalen, The Netherlands) system was implanted into the portal vein to provide non-invasive access for repeated intraportal delivery of cells [24,25]. The catheter was inserted in either a jejunal or splenic vein; the tip was advanced into the portal vein and placed 1-2 cm caudally to the liver hilum.…”

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

“…Catheter‐associated thrombosis was generally described as substantial and common, but methods of assessing this were limited. 269–289 Two studies 271,286 documented evidence of PTE, but most were not designed to evaluate the presence of systemic thrombosis. The short duration of most experiments suggests that catheter‐associated thrombosis can occur rapidly in dogs.…”

Treatment of Canine Multicentric Lymphoma Through Vascular Access Port Versus Peripheral Venous Catheter

“…Utilization of VAP is not a regular practice and is not commonly investigated in the veterinary medicine literature [18]. It is suggested that the device reduces the discomfort caused by PVC, promoting animal welfare with multicentric lymphoma during the long treatment regimen [14].…”