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

Abstract

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.

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

“…A recent prospective randomized trail noted that insertion modality and site had no impact on the early or late complications [4].…”

Complications of total implantable access ports and efficacy of Taurolidine-citrate lock solution against catheter-related infections

“…Despite comprehensive discussion regarding best technique for catheter implantation (dissection vs. puncture), no consensus has been reached so far. [3,4] Recently, however, EJV cut-down catheterisation is preferred because of relatively high risk of various post-and intra-operative complications as well as low success rate of first puncture in paediatric cases. [5] EJV can be easily detected among superficial peripheral thick vessels and are located close to the palpable central veins.…”

The Examination of the Daily Port Use Behaviour and Affecting Factors of Cancer Patients with Implantable Catheter Port

“…15,[19][20][21] Tromboz insidansının erişkin hastalarda geniş aralıklarıyla %0,3-28 oranında değiştiği, bu oranın çocuk hastalarda %12 olduğu saptanmıştır. 23 Ayrıca, literatürde başarıyla yerleştirilen İPK'larda zaman sürecinde tromboz, enfeksiyon, emboli riski yanında aritmi, kardiyak perforasyon, port cebinde hematom, pnömotoraks, ekstravazasyon, kateterin yerinden çıkması gibi önemle belirtilen diğer komplikasyonlar da yer almaktadır. 5,24,25 Çalışmada, hastaların sırasıyla kateter dışına sıvı kaçmasından (%1,1), delinme-portun yerinden oynamasından (%0,5) korktukları saptanmış ve bu bulgunun literatür ile uyumlu olduğu bulunmuş-tur.…”

“…5,24,25 Çalışmada, hastaların sırasıyla kateter dışına sıvı kaçmasından (%1,1), delinme-portun yerinden oynamasından (%0,5) korktukları saptanmış ve bu bulgunun literatür ile uyumlu olduğu bulunmuş-tur. Ribeiro ve ark., port kateterlerde acil gelişen komplikasyon olarak %1,2 oranında pnömotoraks geliştiğini ve bu oranın %1-6 oranında değişim gös-terdiğini; 23 Goltz ve ark. ise erken dönemde port kateterin yerinden ayrılma riskinin %0,4 oranında görüldüğünü, geç dönemde de bu riskin %0,4 olduğunu, aynı dönemde port kateter ile rezervuar arasındaki bağlantı kopmasının %0,1 oranında seyrettiğini belirlemişlerdir.…”