Durability and complication rates of arm-sited central venous access ports (CVAPs) versus chest-sited CVAPs for chemotherapy administration at a rural Australian centre

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 20643-20643
Author(s):  
A. J. Weickhardt ◽  
G. Chong ◽  
S. Shea ◽  
D. Arhanghelschi ◽  
K. Hamilton
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Complication Rates ◽  
Central Venous ◽  
Chemotherapy Administration

scholarly journals The increased risk for thromboembolism pre-cystectomy in patients undergoing neoadjuvant chemotherapy for muscle-invasive urinary bladder cancer is mainly due to central venous access: a multicenter evaluation

2019 ◽  
Vol 52 (4) ◽  
pp. 661-669 ◽  
Author(s):  
Kristoffer Ottosson ◽  
Sofia Pelander ◽  
Markus Johansson ◽  
Ylva Huge ◽  
Firas Aljabery ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Central Venous Access ◽  
Urinary Bladder Cancer ◽  
Venous Access ◽  
Central Venous ◽  
Chemotherapy Administration ◽  
Increased Risk ◽  
Chi Squared ◽  
Muscle Invasive

Abstract Purpose To investigate if patients receiving neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) had an increased risk of thromboembolic events (TEE) and to evaluate when these events occur on a timeline starting from 6 months pre-cystectomy, during NAC-administration and 60 months post-cystectomy. Methods Two hundred and fifty five patients undergoing radical cystectomy during 2009–2014 at three Swedish cystectomy centers (Umeå, Linköping and Sundsvall) were in-detail reviewed retrospectively, using individual medical records. One hundred and twenty nine patients were ineligible for analysis. NAC patients (n = 67) were compared to NAC-naïve NAC-eligible patients (n = 59). The occurrence of TEE was divided into different periods pre-cystectomy and post-cystectomy. Statistical analyses included Chi-squared and logistical regression tests. Results Significant associations were found between receiving NAC and acquiring a TEE during NAC therapy pre-cystectomy. All but one pre-cystectomy event was venous and all but one of the patients received NAC. 31% (14/45) of TEEs occurred pre-cystectomy. The incidence of TEEs pre-cystectomy in NAC-naive NAC-eligible patients was only 10% (2/20), whereas the incidence of TEEs in NAC patients occurred pre-cystectomy in 48% (12/25) and 11/12 incidents were detected during NAC therapy—this including 7/11 (64%) incidents affecting veins in anatomical conjunction with the placement of central venous access for chemotherapy administration. Conclusions There is a significantly increased risk for TEE pre-cystectomy during chemotherapy administration in MIBC patients receiving NAC, compared to the risk in NAC-naïve NAC-eligible MIBC patients. In 64% of the pre-RC TEEs in NAC patients, there was a clinical connection to placement of central venous access.

scholarly journals Supraclavicular versus infraclavicular approach in inserting totally implantable central venous access for cancer therapy: A comparative retrospective study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242727
Author(s):  
Amine Souadka ◽  
Hajar Essangri ◽  
Imad Boualaoui ◽  
Abdelilah Ghannam ◽  
Amine Benkabbou ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Intraoperative Complications ◽  
Central Venous Access ◽  
Venous Access ◽  
Demographic Characteristics ◽  
Success Rates ◽  
Central Venous ◽  
Chemotherapy Administration ◽  
Significant Difference ◽  
Ultrasonographic Guidance

Introduction The insertion of an implantable central venous access is performed according to a variety of approaches which allow the access to the subclavian vein, yet the supraclavicular technique has been underused and never compared to the other methods. The aim of this study was to testify on the efficacy and safety of the subclavian puncture without ultrasound guidance « Yoffa » in comparison with the classical infraclavicular approach (ICA). Material and methods This is a retrospective study with prospective data collection on patients followed at the national oncology institute for cancer, in the period extending from May 1st 2017 to August 31st 2017. All patients had a totally implantable central venous access device inserted by the same surgeon AS for chemotherapy administration and demographic characteristics, as well as procedure details were examined. The primary outcomes were the intraoperative complications, while the secondary outcomes represented immediate postoperative and mid-term complications (at 15 months of follow up). Outcomes were compared between techniques by means of non parametric tests and the Fischer test. Results Our study included 135 patients with 70 patients undergoing the subclavian technique, while 65 were subject to the infraclavicular approach. Both groups had no statistically significant demographic characteristics. The number of vein puncture attempts exceeding once, the accidental artery puncture and operative time were more significant in the ICA group; (39,6 vs 17,6 p = 0,01) (9.2% vs 0; p = 0,01) and (27± 13 vs 23± 8min, p = 0.045) respectively. There was no statistically significant difference in the immediate and midterm complication rate between the two methods 1(1,4) vs 2 (3) p = 0.5. Conclusion In case of unavailability of ultrasonographic guidance, the use of the supra-clavicular landmarks approach is linked to higher success rates and less arterial punctures, thereby proving to be a safe and reliable approach.

Increased Risk of PICC Line Thrombosis in Acute Promyelocytic Leukemia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4499-4499
Author(s):  
Moshe E. Gatt ◽  
Moshe Levin
Keyword(s):  
Acute Promyelocytic Leukemia ◽  
Central Venous Access ◽  
Venous Access ◽  
Infectious Complications ◽  
Promyelocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Complication Rates ◽  
Central Venous ◽  
Picc Line ◽  
Heparin Prophylaxis

Abstract Introduction: Central venous access catheters are being used at increasing rates in the practice of hematology. Although significant complication rates in patients with solid tumors exist, studies have shown a lower incidence of complications in hematology patients. Recently, we noted an increased incidence of percutaneously inserted central catheters (PICC line) thrombosis in patients with acute promyelocytic leukemia (APL). Methods: We undertook an evaluation of the medical records of all adult patients with acute leukemia (AL) from the year 1995 to 2005 at our two hematology centers. All indwelling catheters (of which most are PICC lines) at our institutions are inserted by interventional radiologists under fluoroscopic visualization. The catheters are flushed with saline and heparin prophylaxis was not routinely used during this evaluation period. All thrombotic episodes were diagnosed based on clinical and ultrasound duplex studies. Data was collected in reference to catheters, thrombotic and infectious complications, and relationship to diagnosis and treatment. Results: Of 368 evaluated patients with a central venous catheter and AL, there were 23 incidents of clinically apparent catheter thrombosis (6.2%). The subgroup incidence of catheter thrombosis was nine of 237 (3.8%) patients with acute myelogenous leukemia not including APL (AML), seven of 104 patients (6.7%) with acute lymphoblastic leukemia (ALL), half of the ALL episodes were associated with catheter sepsis, and seven of 25 (28%) with APL. Comparison of the APL group with the AML group is significant at p < 0.03. Conclusion: There appears to be an increased incidence of PICC line thrombosis in APL patients. This may be secondary to the institution of all trans retinoic acid (ATRA) treatment and the thrombophillia of APL. In ALL patients the slightly raised incidence may be due to the thrombophillia of asparaginase or the increased infectious complications of high dose steroids associated with ALL treatment. Based on these findings we would recommend heparin prophylaxis for APL patients with central venous access lines. Following this evaluation we instituted heparin prophylaxis for newly diagnosed APL patients and found no evidence of clinically apparent thrombosis in 8 consecutive patients. There were no episodes of increased bleeding in these 8 APL patients. Further analysis of the data will be presented.

Managing chemotherapy extravasation in totally implantable central venous access: Use of subcutaneous wash-out technique

2020 ◽  
Vol 21 (5) ◽  
pp. 723-731 ◽  
Author(s):  
Abdelkader Taibi ◽  
Sylvia Bardet M ◽  
Sylvaine Durand Fontanier ◽  
Elise Deluche ◽  
Fabien Fredon ◽  
...  
Keyword(s):  
Inflammatory Reaction ◽  
Soft Tissues ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Intravenous Chemotherapy ◽  
Chemotherapy Administration ◽  
Steady Decrease

Background: Totally implanted venous access is widely used in chemotherapy administration. With over 1 million intravenous chemotherapy infusions given worldwide each day, complications are frequent. Accidental cases of extravasation in the presence of a catheter are rare yet very serious and may require discontinuation of chemotherapy. The aim of this study was to evaluate the feasibility and efficacy of the subcutaneous wash-out technique for chemotherapy extravasation treatment. Methods: We retrospectively reviewed the medical charts of patients who had received chemotherapy and sustained extravasation in our hospital between October 2013 and October 2016. Subcutaneous wash-out treatments were carried out exclusively, without the application of antidotes or the use of specific antidotes. Results: We documented seven cases of chemotherapy extravasation. Two cases were treated with antidotes and suffered necrosis in the following weeks. The five patients treated using subcutaneous wash-out had no necrosis and had a steady decrease in the inflammatory reaction of the cutaneous and subcutaneous soft tissues. For these five patients, chemotherapy was restarted within 1 month following extravasation. Conclusion: This study would argue for the feasibility and effectiveness of subcutaneous wash-out in the treatment of chemotherapy extravasations.

Successful Long-Term Central Venous Access

1998 ◽  
Vol 2 (1) ◽  
pp. 38-40
Author(s):  
Franco Tesio ◽  
Hamurabi De Baz ◽  
Giacomo Panarello
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Central Venous
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