Assessement of the complications of Ultrasound and Fluoroscopy-Guided Placement of Totally implantable venous access ports

Özet

Totally implantable venous access systems are widely used in oncology; however, their complications are extremely common whic h, sometimes, require device removal, thereby, leading to delayed chemotherapy and infusion therapies. In this study, we aimed t o investigate the immediate, early, and late complications of venous port implantation in our oncology patients. A total of 219 consecutive cancer patients (111 males, 108 females; mean age: 56.9 years; range: 1 to 81 years) were retrospe ctively analyzed between January 2013 and June 2014. A total of 220 ultrasound- and fluoroscopy-guided totally implantable venous port systems were implanted through the right or left internal jugular vein access. The mean follow-up was 83.7 (range: 2 to 410) days. Overall complication rate was 8.6% (19/220). Eight devices in seven patients were removed due to complications. Two ports were removed in one patient. The complications which required port removal were compromised port-related bloodstream infection (n=5), central venous thrombosis (n=3), and catheter thrombosis (n=1). No major complication or no mortality associated with the port implantation was seen during follow-up. Totally seven immediate complications including local hematoma (n=2), catheter tip retraction (n=2 ), pain (n=1), catheter loop formation (n=1), catheter malposition (n=1), two early complications (n=2; 1 wound dehiscence, and 1 wound infection), and 10 late complications including catheter-related blood stream infection (n=5), central venous thrombosis (n=3), catheter thrombosis (n=1), and tunnel hematoma (n=1) occurred. Low incidence of complications suggest ultrasound- and fluoroscopy-guided venous port implantation is a safe and reliable method for long-term venous access.