Total implantierbarer dauerhafter zentralven�ser Zugang, Langzeiterfahrung mit subcutanen Infusionskammern

Abstract

Subcutaneously implanted infusion chambers represent a new method of central venous access. In 57 evaluable out of 70 patients, four different models of infusion chambers with an accumulative observation time of 57 years were implanted. In 72% of the patients, up to 12 cycles of polychemotherapy were administered. Parenteral nutrition and blood drawing were also performed. After 4,970 punctions of the system and 12.2 years of use 46 complications in 38 patients were observed, however, most were minor ones, such as temporary occlusions (12) and extravasations (14). Septum luxation (1), septum perforation (1), catheter fracture (1) and catheter migration (2) as well as 7 cases of septicemia or port-pocket-infection required explanation. Infusion chambers seem to be particularly suitable for intermittent and long-term chemotherapy and emergency bolus injections with a significant advantage (10 complications per one thousand days of use) compared to externally placed venous catheters. However, follow-up and care must be performed by a skilled team.

Prospective Assessment of Catheter Migration in Implanted Vascular Access Devices for Adjuvant Colorectal Cancer Chemotherapy

“…VADs are thus the cornerstone in medical oncology, but linked with complications of which catheter migration is potentially hazardous. Symptomatic catheter migration has been reported in 0% -3.5% of patients, and has usually been considered a minor complication which results in catheter malfunction and patient discomfort [11][12][13][14][15]. The 3/88 (3.4%) in our randomized material is among the highest noted.…”

“…The most typical long-term complications are thrombosis and infection, but rarer complications are skin damage, vascular erosion, catheter pinch-off and migration [10]. The frequency of catheter tip migration, even after adequate initial positioning, to an undesirable position is seen in 0% -3.5% of cases [11][12][13][14][15]. However, the definition of catheter migration in these series varies and the percentage of cases with full reversal of catheter to an unintended vein is unknown.…”