Totally implantable venous access port systems and associated complications: A single-institution retrospective analysis of 2,996 breast cancer patients

Abstract

Abstract. Totally implantable venous access port systems (TIVAPS) are widely used in breast cancer patients. However, complications are frequent and may necessitate device replacement or removal, resulting in additional patient stress and treatment delays. The aim of the present study was to investigate possible risk factors for complications. A total of 2,996 consecutive female breast cancer patients, with a median age of 50.2 years (range, 21.2-85.5 years) were enrolled in this observational, single-centre study between December, 2008 and April, 2014. TIVAPS implantation was principally performed using local anaesthesia and the blind puncture or Seldinger technique through internal jugular or subclavian vein access. A retrospective chart review was conducted to obtain information associated with TIVAPS and patient data. Insertion performed by blind puncture and Seldinger technique had a success ratio of 96.34 and 99.80%, respectively (χ 2 =29.905, P<0.001). However, the success ratio of the puncture technique group was 99.76% when the TIVAPS was implanted in the right internal jugular vein. The most common complications were late complications, with an overall incidence rate of 5.41% (162/2,996) during the entire device duration. The most common late complications included fibrin formation (1.84%, 55/2,996), port-related bacteraemia (1.44%, 43/2,996) and deep vein thrombosis (0.63%, 19/2,996). No patient died during the study. Our results demonstrated that insertion of TIVAPS by blind puncture or the Seldinger technique through internal jugular or subclavian vein access is convenient, and insertion by the Seldinger technique through the right internal jugular vein is the preferred method. Therefore, TIVAPS is safe for continuous infusional chemotherapy regimens for breast cancer patients.

Complications of totally implantable venous access devices: experience with 852 Moroccan cancer patients

“…In many retrospective studies, the complication rate varied between 6 and 21% and is consistent with the findings. 2,5,7,[9][10][11][12][13][14][15][16][17][18][19][20] Furthermore, in accordance with recent studies, author observed a decreasing trend for early complications. 21 Rare major complication as described in case series reports, such as air embolism, hemothorax, brachial plexus injury and pericardial tamponade did not occur in the series.…”

Totally Implantable Central Venous Port Catheters: Radiation Exposure as a Function of Puncture Site and Operator Experience

“…Moureau et al reported for 696.370 port catheter days a complication rate of 0.52/1,000 catheter days, whereas infections were described in 0.30/1,000 catheter days and dysfunctions in 0.21/1,000 catheter days (37). The risk of thrombosis is higher if the port system is inserted through the subclavian vein compared to the internal jugular vein (38,39). Furthermore, the stenosis rate is lower with insertion in the jugular vein due to its large diameter and high blood flow (40).…”

Metastatic spread from squamous cell carcinoma of the hypopharynx to the totally implantable venous access port insertion site: Case report and review of literature

“…In patients receiving continuous infusion of chemotherapy, a totally implantable venous access port plays a central role in allowing the delivery of chemotherapy in the outpatient setting. The most common complications associated with totally implantable venous access port are hemorrhage, pneumothorax, hemothorax, infection, and venous thrombosis . Metastatic spread at the site of the insertion of a totally implantable venous access port is an extremely rare complication, although there are some case reports in Western literature .…”

“…The most common complications associated with totally implantable venous access port are hemorrhage, pneumothorax, hemothorax, infection, and venous thrombosis. 2 Metastatic spread at the site of the insertion of a totally implantable venous access port is an extremely rare complication, although there are some case reports in Western literature. [3][4][5][6] This is the first case report of a patient with squamous cell carcinoma (SCC) of the hypopharynx who developed tumor seeding not only at the site of the totally implantable venous access port insertion but also along the tunnel tract of the catheter itself.…”