Abstract No. 589 Characterizing the extent and impact of catheter tip movement on chest port dysfunction

2019 ◽  
Vol 30 (3) ◽  
pp. S254
Author(s):  
R. Abboud ◽  
N. Cypro ◽  
C. Zinsmeister ◽  
V. Shivaji ◽  
K. Dickey ◽  
...  
Keyword(s):  
2018 ◽  
Vol 34 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Mina S Makary ◽  
Alexander Lionberg ◽  
Mamdouh Khayat ◽  
Maryam B Lustberg ◽  
Jamal AlTaani ◽  
...  

Purpose Catheter-tip associated thrombosis is not uncommon in patients with implantable central venous ports; however, the prevalence and clinical impact of this complication on patient management is unclear. This study aims to identify risk factors for thrombus formation in a large population receiving serial echocardiograms (echo) following port placement. Methods A total of 396 female breast cancer patients underwent internal jugular vein chest port placement between 2007 and 2013 and received echo studies every third month. Catheter tip position was measured from chest radiography and catheter associated thrombus was identified by echo. Results Sixteen out of 396 patients (4%) had catheter-tip thrombus. No patients were symptomatic or prophylactically anticoagulated. Patients with thrombus were significantly younger than those without (46.4 years versus 53.4 years, respectively, p = 0.02) and had higher stage breast cancer with 75% versus 44.7% having stage III or IV cancer ( p = 0.017). Thrombus was identified after a median of 91 days. No significant difference was identified in anatomic ( p = 0.1) or measured ( p = 0.15) tip position, port laterality ( p = 0.86), or number of port lumens ( p = 0.65). Conclusions In this large cohort, younger patients and those with more advanced stage breast cancer were more associated with catheter-tip-related thrombus after port placement.


2004 ◽  
Vol 15 (6) ◽  
pp. 581-587 ◽  
Author(s):  
Jakob C.L. Schutz ◽  
Aalpen A. Patel ◽  
Timothy W.I. Clark ◽  
Jeffrey A. Solomon ◽  
David B. Freiman ◽  
...  

2020 ◽  
Vol 27 (10) ◽  
pp. 1600-1615 ◽  
Author(s):  
Jorge Aramburu ◽  
Raúl Antón ◽  
Alejandro Rivas ◽  
Juan C. Ramos ◽  
Bruno Sangro ◽  
...  

Radioembolization (RE) is a valuable treatment for liver cancer. It consists of administering radioactive microspheres by an intra-arterially placed catheter with the aim of lodging these microspheres, which are driven by the bloodstream, in the tumoral bed. Even though it is a safe treatment, some radiation-induced complications may arise. In trying to detect or solve the possible incidences that cause nontarget irradiation, simulating the particle- hemodynamics in hepatic arteries during RE by computational fluid dynamics (CFD) tools has become a valuable approach. This paper reviews the parameters that influence the outcome of RE and that have been studied via numerical simulations. In this numerical approach, the outcome of RE is regarded as successful if particles reach the artery branches that feed tumor-bearing liver segments. Up to 10 parameters have been reviewed. The variation of each parameter actually alters the hemodynamic pattern in the vicinities of the catheter tip and locally alters the incorporation of the particles into the bloodstream. Therefore, in general, the local influences of these parameters should result in global differences in terms of particle distribution in the hepatic artery branches. However, it has been observed that under some (qualitatively described) appropriate conditions where particles align with blood streamlines, the local influence resulting from a variation of a given parameter vanishes and no global differences are observed. Furthermore, the increasing number of CFD studies on RE suggests that numerical simulations have become an invaluable research tool in the study of RE.


2008 ◽  
Vol 0 (0) ◽  
Author(s):  
Camila Marconi ◽  
Maria de Lourdes R. de Souza da Cunha ◽  
João C. Lyra ◽  
Maria R. Bentlin ◽  
Jackson E. N. Batalha ◽  
...  

2020 ◽  
Vol 13 (4) ◽  
pp. e233140
Author(s):  
Jacob Levi ◽  
Karl Chopra ◽  
Mubashar Hussain ◽  
Shafiul Chowdhury

A 72-year-old man presented with urinary retention, weight loss, haematuria and severe acute kidney injury. He had never before been admitted to hospital and his past medical history included only an inguinal hernia. On examination, he appeared uraemic and had a right-sided painful hernia. A three-way catheter was inserted, bladder washouts performed and irrigation started. An ultrasound showed severe bilateral hydronephrosis and a ‘thickened bladder’ and this was thought to be obstructive uropathy secondary to bladder cancer. Twenty-four hours later his hernia doubled in diameter, became incarcerated and a CT of the abdomen and pelvis showed an inguinal hernia of both bladder and bowel, with the catheter tip inside the bladder hernia. He was taken to theatres and an open mesh repair was performed with a rigid cystoscopy to assist in locating and reducing the bladder. He required intensive care and dialysis postoperatively and remains on regular dialysis following discharge.


2021 ◽  
pp. 112972982110090
Author(s):  
Nicholas Mielke ◽  
Steven Johnson ◽  
Patrick Karabon ◽  
Amit Bahl

Objective: Thrombophlebitis associated with peripheral intravenous catheters (PIVCs) is a poorly described complication in the literature. Given limited accuracy of current assessment tools and poor documentation in the medical record, the true incidence and relevance of this complication is misrepresented. We aimed to identify risk factors in the development of thrombophlebitis using an objective methodology coupling serial diagnostic ultrasound and clinical assessment. Methods: We conducted a single-site, prospective observational cohort study. Adult patients presenting to the emergency department that underwent traditionally placed PIVC insertion and were being hospitalized with an anticipated length of stay greater than 2 days were eligible participants. Using serial, daily ultrasound evaluations and clinical assessments via the phlebitis scale, we identified patients with asymptomatic and symptomatic thrombosis. The primary goal was to identify demographic, clinical, and IV related risk factors associated with thrombophlebitis. Univariate and multivariate analyses were employed to identify risk factors for thrombophlebitis. Results: A total of 62 PIVCs were included between July and August 2020. About 54 (87.10%) developed catheter-related thrombosis with 22 (40.74%) of the thrombosed catheters were characterized as symptomatic. Multivariate cox regression demonstrated that catheter diameter relative to vein diameter greater than one-third [AHR = 5.41 (1.91, 15.4) p = 0.0015] and angle of distal tip of catheter against vein wall ⩾5° [AHR = 4.39 (1.39, 13.8) p = 0.0116] were associated with increased likelihood of thrombophlebitis. Conclusions: Our study found that the increased proportion of catheter relative to vein size and steeper catheter tip angle increased the risk of thrombophlebitis. Catheter size relative to vein size is a modifiable factor that should be considered when inserting PIVCs. Additional larger prospective investigations using objective methodologies are needed to further characterize complications in PIVCs.


Sign in / Sign up

Export Citation Format

Share Document