Complications and pitfalls of central venous port catheters: experience with 782 patients with cancer
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ORIGINAL ARTICLE
Complications and pitfalls of central venous port catheters: experience with 782 patients with cancer Mehmet Emin Ince 1 & Gökhan Ozkan 1 & Nadide Ors 1 & Alperen Kutay Yildirim 2 & Suat Doganci 3 Received: 31 January 2020 / Accepted: 5 March 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background The clinical use of port catheters has become widespread because they provide a safe and easy vascular route. Such widespread use of vascular port catheters has revealed early and late complications. Aim This study was evaluated the early and late noninfectious complications and present precautions and pitfalls to handle these complications. Methods The retrospective observational study comprised 801 vascular port catheters inserted into 782 adult patients for various reasons between 2010 and 2018. Patient demographic, indications for port catheter implantation, port catheter types, and insertion sides were noted. Port catheter implantation related early and late complications were recorded. Results The subclavian vein was selected as a target vein in almost all of the interventions (98.9%). Similarly, right-sided veins were used in about 90% of patients. The most common problem was technical issues related to the interventions. If venous cannulation was challenging, ultrasonography and fluoroscopy guidance roadmap technique were used. Most serious complication was pneumothorax in 7 patients. In the late period, the most common problem was thrombotic occlusion of the catheter. In two-thirds of these patients, thrombolytic therapy for thrombosed port catheters may rescue some catheters and avoid secondary port catheter insertions. Conclusions Despite these benefits, port catheters are associated with various complications. However, most of these complications can be effectively prevented by proper techniques and easily applied precautions. Keywords Catheterization . Fluoroscopy . Port catheters . Thrombolytic therapy . Ultrasonography
Introduction Patients with cancer often require vascular access for chemotherapy, parenteral nutrition, fluids, antibiotics, and recurrent blood sampling. These recurrent venous interventions reduce the patient’s quality of life and complicate tolerance to their treatment. Since the first implantation of a totally implantable venous access device by Niederhuber et al. in 1982 [1], port catheters have become routine tools for the management of patients with cancer because they provide a safe and reliable vascular path for this
* Mehmet Emin Ince [email protected] 1
Department of Anesthesiology and Reanimation, Gülhane Training and Research Hospital, 06010 Ankara, Turkey
2
Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
3
Department of Cardiovascular Surgery, Gülhane Training and Research Hospital, Ankara, Turkey
purpose. The most popular vascular port insertion sites are the internal jugular (IJV) and subclavian veins. When these veins are unavailable, the femoral vein may be alternative access site [2, 3]. Suc
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