Evaluation of complications of totally implantable central venous port system insertion

Kim,Dong   Hyun; Ryu,Dong   Yeon; Jung,Hyuk   Jae; Lee,Sang   Su

doi:10.3892/etm.2019.7185

Evaluation of complications of totally implantable central venous port system insertion

Authors:
- Dong Hyun Kim
- Dong Yeon Ryu
- Hyuk Jae Jung
- Sang Su Lee
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Affiliations: Department of Surgery, Vascular and Endovascular Division, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam 50612, Republic of Korea
Published online on: January 18, 2019 https://doi.org/10.3892/etm.2019.7185
Pages: 2013-2018
Copyright: © Kim et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to describe the procedure of totally implantable central venous port system (TICVPS) insertion performed at our center and investigate associated complications. The study retrospectively evaluated 827 patients who underwent a single‑type TICVPS insertion from January 2013 to July 2015. The length of the procedure, long‑term device function, angle (chamber‑to‑tip) and complications of TICVPS, including infection, skin erosion, occlusion, malposition and thrombosis, were analyzed from the patients' medical records. A total of 843 TICVPS insertions were performed in 827 patients. The TICVPS implantation was successful in all cases (100%). A total of 34 cases (4.0%) with complications were recorded. Complications at the chamber insertion site occurred in 11 patients (1.3%), including 5 infection (0.6%) and 6 erosion cases (0.7%). All patients with chamber insertion site infection were treated by administration of antibiotics and dressing. Of the patients in which chamber insertion site erosion occurred, 2 were subjected to TICVPS removal and reinsertion and 4 were treated with debridement, irrigation and resuture. The most common type of complication was catheter‑associated (2.3%; n=19). Among these cases, 7 had catheter‑associated infection (0.8%), 8 had catheter migration (1.0%) confirmed by chest radiography, 4 had catheter‑associated thrombosis (0.5%) and 2 had chamber malposition (0.3%). The present retrospective study on TICVPS, which used a relatively large cohort, demonstrated a low complication rate (4.0%) compared with that reported in previous studies (5‑20%). A well‑designed procedure, experienced vascular surgeons, an aseptic operating room environment, ultrasound‑guided puncture, a wide angle (chamber‑to‑tip) and the use of fluoroscopy with contrast agent may reduce the complication rate of TICVPS insertion.

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