Effectiveness of mechanical recanalization for intraluminal occlusion of totally implantable venous access ports

2021 ◽  
pp. 112972982110346
Author(s):  
Woo Jin Yang ◽  
Myung Gyu Song ◽  
Tae-Seok Seo ◽  
Sung-Joon Park
Keyword(s):  
Interventional Radiology ◽  
Medical Records ◽  
Thrombolytic Agent ◽  
Venous Access ◽  
Normal Function ◽  
Access Port ◽  
Mechanical Recanalization ◽  
Venous Access Port ◽  
Mechanical Injection ◽  
Median Interval

Purpose: To evaluate if the mechanical injection of saline is effective in restoring patency of a totally implantable venous access port (TIVAP) with an intraluminal occlusion. Materials and methods: From January 2017 to June 2019, 64 cases of dysfunction of a TIVAP were referred to interventional radiology. Among these, 16 cases showed normal function of the TIVAP, 19 cases the showed the appearance of a fibroblastic sheath, and 29 cases showed intraluminal occlusion. Mechanical recanalization was performed for intraluminal occlusion of the TIVAP with an indeflator and a 20G non-coring needle. Linograms were performed in all recanalized cases. The success or failure of recanalization and the pressure of the indeflator were recorded. Linograms were evaluated for breakage or migration of catheters. Medical records were retrospectively reviewed. Results: Among the 29 intraluminal occlusion cases, 24 cases (82.7%) were recanalized by mechanical recanalization via an indeflator. The pressure of the indeflator ranged from 29 to 220 psi (median: 118 psi). Linograms revealed breakage of the catheter of the TIVAP in two failed cases. The median interval from implantation to dysfunction was 405 days (range: 43–1723 days). The median interval from last use to dysfunction was 8 days (mean: 15.4 days; range: 1–119 days). The median re-occlusion free period after successful mechanical recanalization was 100.5 days (range: 6–859 days). Conclusion: In the absence of an available thrombolytic agent, mechanical injection of saline was a tolerable alternative method for restoring occluded catheters and sustaining the function of catheters. Because breakage of the catheter can occur during mechanical recanalization of a TIVAP, a linogram should follow the procedure.

Totally Implantable Venous Access Port Systems: Implant Depth-based Complications in Breast Cancer Therapy - A Comparative Study

2021 ◽  
Vol 27 ◽  
Author(s):  
Kuo Chen ◽  
Narasimha M. Beeraka ◽  
Yuanting Gu ◽  
Jingruo Li ◽  
Mikhail Sinelnikov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Therapy ◽  
Venous Access ◽  
Breast Cancer Patients ◽  
Breast Cancer Therapy ◽  
Access Port ◽  
Group A ◽  
Venous Access Port ◽  
Group B ◽  
Group D

Background: Totally implantable venous access port system (TIVAPS) is widely used in breast cancer therapy; TIVAPS has several associated complications depending on the depth of implantation in breast cancer (BC) patients during continuous infusional chemotherapy regimens. The purpose of this study is to find out the optimal depth of TIVAPS implantation to reduce the incidence of complications during infusional chemotherapy. Methods: This study reviewed the depth TIVAPS implantation in the internal jugular vein in 1282 breast cancer patients over a ten-year period (2009-2019), and associated complications. We segregated the patients as 5 groups: ‘Group A (depth < 4 mm), Group B (depth of 4-8 mm), Group C (depth of 8-12 mm), and Group D (depth of 12-16 mm), and Group E (depth of > 16 mm)’. Consequently, the ‘internal complications’ such as infection, venous thrombotic syndrome, catheter folding & migration, extravasation, whereas the ‘external complications’ viz., inflammation, local hematoma, local cutaneous reactions, and port exteriorization were significantly analyzed during TIVAPS implantation at different depths in BC patients. Results: Overall incidence of ‘internal complications’ such as infections, venous thrombotic syndrome, catheter folding & migration, and extravasation was comparatively lesser in Group C (8-12 mm) than Group A, Group B, Group D, and Group E, respectively. Mainly, the external complications such as inflammation Group C (8-12 mm) (p<0.01) were lesser (6.8%, 3/44 cases) than Group A, Group B, Group D, Group E. On a similar note, the local hematoma, and local cutaneous reaction, and port exteriorization were observed as ‘5% (1/20 cases), 4.2% (2/47 cases), and (3.2%, 1/31 cases)’ in Group C patients (p<0.01), which were comparatively lesser than the other groups. Conclusion: Subcutaneous implantation of TIVAPS at a depth of 8-12 mm could be preferred due to the lowest incidence of internal and external complications compared to the incidence of these complications in other groups; this depth could be referred to as the safe and convenient implantation depth for the effective delivery of chemotherapy regimen in BC patients without difficulty in transcutaneous access to the port.

scholarly journals Migration of catheter of a totally implantable venous access port to right thoracic cavity in a child - a case report

2021 ◽  
Author(s):  
Qiteng Xu ◽  
Yueyi Ren ◽  
Yifei Hu ◽  
Shuhua Duan ◽  
Rui Chen ◽  
...  
Keyword(s):  
Venous Access ◽  
Thoracic Cavity ◽  
Severe Condition ◽  
Access Port ◽  
Intravenous Antibiotics ◽  
Catheter Tip ◽  
Life Threatening ◽  
Venous Access Port ◽  
And Migration ◽  
The Right

Abstract BackgroundThe totally implantable venous access port (TIVAP) is a secure and practical choice for children undergoing long-term chemotherapy. Nevertheless, various complications still need to be treated cautiously. Among the complications, the migration of catheters to the thoracic cavity is a very rare (but potentially severe) condition that may necessitate device reimplantation. Furthermore, this migration may even be life-threatening if it is not detected in time.Case presentationA 1-year-old girl undergoing palliative chemotherapy underwent TIVAP placement via the right internal jugular vein. During the operating procedure, the catheter tip was located in the right atrium, which was confirmed by the use of C-arm. Prophylactic intravenous antibiotics were then adopted with routine aspiration and with flushing being conducted each time before administration. Massive right pleural effusion and migration of the catheter tip to the right thoracic cavity were detected on the 2nd day after implantation, which resulted in the removal and reimplantation of the TIVAP device.ConclusionsThe migration of the catheter into the thoracic cavity should be considered a possible complication of TIVAP implantation in children. Early detection and reimplantation may provide opportunities for the prevention of further severe complications.

scholarly journals Characteristics of Symptomatic Axillary Vein Thrombosis After Placement of Totally Implanted Venous Access Port in Cancer Patients

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Myung Gyu Song ◽  
Tae-Seok Seo ◽  
Woo Jin Yang
Keyword(s):  
Lung Cancer ◽  
Pancreatic Cancer ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Venous Access ◽  
Axillary Vein ◽  
Access Port ◽  
Vein Thrombosis ◽  
Axillary Vein Thrombosis ◽  
Venous Access Port

Background: The incidence of venous thrombosis based on access route after implantation of the totally implanted venous access port (TIVAP) is controversial. Symptomatic TIVAP-related venous thrombosis remains relatively rare. However, characteristics of symptomatic axillary vein thrombosis after TIVAP implantation via access of the axillary vein has not been reported. Objectives: In this historical cohort study, the incidence and characteristics of venous thrombosis associated with TIVAP via the axillary vein in cancer patients were evaluated. Patients and Methods: A total of 4,773 TIVAPs were placed via the axillary vein in patients with various types of cancer between May 2012 and July 2018. Eighteen patients experienced symptomatic venous thrombosis associated with TIVAPs. Radiologic findings for venous thrombosis were evaluated using computed tomography (CT) including scans of the axillary vein. Medical records were retrospectively reviewed. Results: The prevalence of symptomatic thrombosis was 0.38% (18/4,773). The patients with symptomatic venous thrombosis included 14 males and four females. Among the 18 patients, the most common types of cancer were lung cancer (n = 7) and pancreatic cancer (n = 4), with the incidence rates of 0.79% (lung cancer, 7/882) and 1.58% (pancreatic cancer, 4/253), respectively. The median time between placement of the TIVAP and diagnosis of thrombosis was 35.5 days (range: 6 - 292 days). All symptomatic patients had thrombosis in the axillary vein on CT images. Symptoms were improved in all patients with treatment including removal of TIVAP at the time of diagnosis and following anticoagulation therapy. From the multiple binary logistic regression, pancreatic cancer and lung cancer were statistically significant risk factors of symptomatic axillary vein thrombosis. Conclusion: After insertion of TIVAPs through the axillary vein, symptomatic axillary vein thrombosis rarely developed. Pancreatic cancer and lung cancer were associated with the risk of symptomatic axillary vein thrombosis.

Risk Factors for Totally Implantable Central Venous Access Port-related Infection in Patients With Malignancy

2021 ◽  
Vol 41 (3) ◽  
pp. 1547-1553
Author(s):  
SATORU FURUHASHI ◽  
YOSHIFUMI MORITA ◽  
SHINYA IDA ◽  
RYUTA MURAKI ◽  
RYO KITAJIMA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Access Port ◽  
Venous Access Port
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