Improved methods for venous access: the Port-A-Cath, a totally implanted catheter system.

1986 ◽  
Vol 4 (4) ◽  
pp. 596-603 ◽  
Author(s):  
S Strum ◽  
J McDermed ◽  
A Korn ◽  
C Joseph
Keyword(s):  
Venous Access ◽  
Intravenous Therapy ◽  
Infusion Chemotherapy ◽  
Maintenance Schedule ◽  
Access System ◽  
Care Protocol ◽  
Catheter System ◽  
Continuous Infusion Chemotherapy ◽  
Improved Methods

We prospectively evaluated the performance and rate of long-term complications with the Port-A-Cath (PAC), a totally implanted vascular access system. Two catheter styles were evaluated, a small-bore (SB) catheter (0.51-mm diameter) and a large-bore (LB) catheter (1.02-mm diameter), in conjunction with the use of a strict catheter care protocol. The PAC performed well, and with both SB and LB systems, no significant extravasation, skin necrosis, hematoma, septum damage or leakage, or subcutaneous portal infections occurred after 7,240 days of implantation and 1,435 days of use. Complications with the PAC system consisted of catheter occlusion (seven patients, 21.5%) and one instance of possible catheter infection (3.1%). Occlusions were limited to patients implanted with the SB catheter (seven of 16, 43.8%), and five of the seven (71.4%) occurred in patients receiving continuous infusion chemotherapy and/or total parenteral nutrition. Patency of the PAC system was maintained using a regular flushing schedule once every 30 days, a significant advantage compared with the daily maintenance schedule required with externally placed venous catheters. The results of this study suggest that the PAC system can provide a safe and reliable method for venous access in patients requiring intermittent or prolonged intravenous therapy.

Vascular access by physician assistants: evaluation of an implantable peripheral port system in cancer patients.

1995 ◽  
Vol 13 (6) ◽  
pp. 1513-1519 ◽  
Author(s):  
E B Rubenstein ◽  
A Fender ◽  
K V Rolston ◽  
L S Elting ◽  
P Prasco ◽  
...  
Keyword(s):  
Vascular Access ◽  
Physician Assistants ◽  
Ambulatory Setting ◽  
Infusion Therapy ◽  
Port Catheter ◽  
New Device ◽  
Access System ◽  
Catheter System ◽  
Port System

PURPOSE To determine the ability of a physician assistant (PA) to insert, in an ambulatory setting, a peripheral subcutaneous implanted vascular-access device (VAD) and to evaluate the ability to transfer this training to a second PA. We also evaluated the performance and complications associated with this new device. PATIENTS AND METHODS The Peripheral Access System (PAS) Port catheter system (Sims-Deltec Inc, St Paul, MN) was inserted in patients who required long-term (> 3 months) vascular access for infusion therapy. RESULTS The first PA (PA-1) successfully inserted 57 of 62 devices (92%) after gaining experience with the technique in 10 patients (success rate, five of 10 [50%]; P = .003). The second PA (PA-2) was successful in eight of 10 initial attempts (80%) and 25 of 30 overall (83%). Complications were few and limited to phlebitis, thrombosis, and a low infection rate (0.2 per 1,000 catheter days). CONCLUSION PAs can be taught to insert a peripheral subcutaneous implanted VAD. This technique is transferable from one PA to another, and the device studied is appropriate for outpatient VAD programs.

Infection of totally implantable venous access devices: A review of the literature

2018 ◽  
Vol 19 (3) ◽  
pp. 230-242 ◽  
Author(s):  
Fulvio Pinelli ◽  
Elena Cecero ◽  
Dario Degl’Innocenti ◽  
Valentina Selmi ◽  
Rosa Giua ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Access ◽  
Outpatient Setting ◽  
Intravenous Therapy ◽  
Access Device ◽  
Venous Access Device ◽  
Treatment Of Infection ◽  
Venous Access Devices

Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient’s quality of life. Nonetheless, totally implantable venous access devices are not free from complications. Among those, infection is the most relevant, affecting patients’ morbidity and mortality—both in the hospital or outpatient setting—and increasing healthcare costs. Knowledge of pathogenesis and risk factors of totally implantable venous access device–related infections is crucial to prevent this condition by adopting proper insertion bundles and maintenance bundles based on the best available evidence. Early diagnosis and prompt treatment of infection are of paramount importance. As a totally implantable venous access device–related infection occurs, device removal or a conservative approach should be chosen in treating this complication. For both prevention and therapy, antimicrobial lock is a major matter of controversy and a promising field for future clinical studies. This article reviews current evidences in terms of epidemiology, pathogenesis and risk factors, diagnosis, prevention, and treatment of totally implantable venous access device–related infections.

Continuous infusion chemotherapy: a critical review.

1984 ◽  
Vol 2 (11) ◽  
pp. 1289-1304 ◽  
Author(s):  
N J Vogelzang
Keyword(s):  
Continuous Infusion ◽  
Therapeutic Index ◽  
Venous Access ◽  
Chemotherapeutic Agents ◽  
Infusion Therapy ◽  
Infusion Chemotherapy ◽  
Antineoplastic Effect ◽  
Randomized Controlled Studies ◽  
Continuous Infusion Chemotherapy ◽  
The Cost

With the development of reliable drug pumps and safe long-term venous access catheters, the continuous infusion of chemotherapeutic agents has become clinically feasible. The available studies on infusion therapy with 37 antineoplastic drugs are analyzed. With the majority of agents, infusion studies have either not been performed or the completed studies have failed to demonstrate improved effectiveness over bolus therapy. In some continuous infusion studies, effectiveness has been retained but with no apparent improvement in the therapeutic index. Several other drugs such as bleomycin, cytosine arabinoside, and doxorubicin have apparent improvement in the therapeutic index when given as a continuous infusion. The improved therapeutic index of the fluorinated pyrimidines when given via continuous infusion must be explored in randomized controlled studies using malignancies other than colorectal cancer. The cost effectiveness of such studies must be carefully assessed. Since this method of administration of chemotherapeutic agents offers the potential for less toxicity and retained antineoplastic effect, such investigations are highly desirable for improved patient care.

A totally implantable venous access system for long-term chemotherapy in children

1985 ◽  
Vol 20 (6) ◽  
pp. 725-727 ◽  
Author(s):  
Bruce McGovern ◽  
Robert Solenberger ◽  
Kenneth Reed
Keyword(s):  
Venous Access ◽  
Access System

scholarly journals Totally Implantable Venous Access Device (Chemoport) in Oncology: Study of 168 Polyurethane Chemoport Catheter System

2021 ◽  
Vol 10 (04) ◽  
pp. 261-264
Author(s):  
Gyanendra Swaroop Mittal ◽  
Deepak Sundriyal ◽  
Niranjan B. Naik ◽  
Amit Sehrawat
Keyword(s):  
Cancer Patients ◽  
Venous Access ◽  
Access Device ◽  
Vein Thrombosis ◽  
Catheter System ◽  
Catheter Tip ◽  
Polyurethane Catheters ◽  
Venous Access Device ◽  
Deep Vein

Abstract Background Chemoport (totally implantable venous access device) and its catheter system are used to administer long-term chemotherapy in cancer patients. The objective of this study was to analyze the complications associated with chemoport insertion in various cancer patients. Material and Methods A total number of 168 chemoports along with polyurethane catheters were inserted in various cancer patients over a period of 3 years. 9.6 F polyurethane catheters were put by a team of surgical oncologists in operation theater under general or local anesthesia. Analysis of the complications was done until the chemoport was removed due to any reason. Results Out of 168 patients, 30 (17.85%) developed complications. Complications included arterial puncture, malposition of the catheter tip, pneumothorax, hematoma, seroma, deep vein thrombosis, fracture of the catheter, a reversal of port, infections, and thrombosis of the catheter. Only a few required premature port and catheter removal. Conclusion There was a low rate of complications associated with chemoport using a polyurethane type of catheter system. However, infection-related complications were comparatively more common in our series. Chemoport requires expert handling, patient education, strict follow-up, and dedicated teamwork to minimize complications.

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