Subcutaneous ports in the radiology suite: an effective and safe procedure for care in cancer patients

Abstract

The purpose of the study is to present our experience and compare the results of the three types of ports used as a central venous access and performed in the radiology suite. Between March 1989 and November 1993 we performed 288 implantations (100 Implantofix Seldinger, 100 plastic Hickman port, and 88 stainless steel Port-a-cath) for chemotherapeutic treatment on the same number of patients diagnosed as having cancer. In all cases access was obtained via a subclavian vein (the left one in 185 cases and the right one in 103). All the system ports were implanted in the radiology suite. In all cases the procedure was successfully performed. Complications occurred in 26.3% of cases, most notably thrombosis in 13 cases (4.5%) and infection in 12 cases (4.1%). Duration of the port systems placement varied between 17 and 1467 days (a mean of 315 days). A total of 133 systems have been removed to date, 80 (60.%) due to termination of chemotherapy, and 53(40%) for treatment of complications. Significant differences (complications and port duration time) were not observed between the three types of reservoir used. Subcutaneous ports are safe, comfortable, and effective devices for central venous access.

Comparison of Implantable Central Venous Ports:Subclavian Versus Juguler Access

“…Many oncology patients require easy vascular access for delivery of chemotherapy, other intravenous treatments such as fluids, blood products and parenteral nutrition solutions [1,2]. They have great advantages over tunnelled catheters in terms of low infection rates, long patient life, patient comfort and ambulatory treatment [3][4][5].…”

Thrombotic Complications of Central Venous Catheters in Cancer Patients

“…In those that are symptomatic, symptoms include arm/neck/head swelling or pain, headache, numbness of the extremity, erythema of the extremity, phlegmasia, venous distention, and jaw pain. Table 3 lists the studies in which patients with CVCs developed symptoms and then had clots in the affected blood vessel documented by venogram or ultrasound [22,25,[27][28][29][30][31][32][33][34][35][36][37][38][39]. On average, 12% of all patients with CVCs developed symptomatic thrombi but there was a wide range, from 5%-41% of all CVC insertions.…”

Implantation of central venous ports with catheter insertion via the right internal jugular vein in oncology patients—single center experience

“…However, totally implantable access ports (TIAP) represent a more comfortable alternative with lower prevalence of septic complications in oncology patients [4,8]. The catheter of the TIAP is inserted most frequently via the subclavian vein [1,5,10]. Despite the frequent introduction of externalized venous catheters via the internal jugular vein, there are only limited reports of venous ports implantation using this venous approach [11,19].…”