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Published in: World Journal of Surgery 11/2011

01-11-2011

Catheter Fracture of Intravenous Ports and its Management

Authors: Ching-Yang Wu, Jui-Ying Fu, Po-Hao Feng, Tsung-Chi Kao, Sheng-Yueh Yu, Hao-Jui Li, Po-Jen Ko, Hung-Chang Hsieh

Published in: World Journal of Surgery | Issue 11/2011

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Abstract

Background

Intravenous ports are widely used for oncology patients. However, catheter fractures may lead to the need for re-intervention. We aimed to identify the risk factors associated with catheter fractures.

Methods

Between January 1 and December 31, 2006, we retrospectively reviewed the clinical data and plain chest films of 1,505 patients implanted with an intravenous port at Chang Gung Memorial Hospital. Different vascular sites were compared using the chi-square or Fisher’s exact test for categorical variables, and the t test was used for continuous variables with normal distribution; P < 0.05 was considered statistically significant.

Results

There were 59 and 1,448 procedures in the fracture and non-fracture groups, respectively. Monovariate analysis revealed that the risk factors for catheter fracture were as follows: large angle (P < 0.0001), female gender (P < 0.0008), subclavian route (P < 0.0001), and port type Arrow French (Fr.) 8.1 (P < 0.0001). Because these risk factors showed no interaction effects, they were all considered independent risk factors. When all factors were considered together, all risk factors, except angle and age, retained their statistical significance.

Conclusions

Most catheter fractures were caused by material weakness. If catheter fracture is confirmed, further intervention for port and catheter removal is recommended. Female gender, intravenous port implantation via the subclavian route, and the Arrow Fr. 8.1 port were found to be risk factors. Patients with these risk factors should be monitored closely to avoid catheter fractures.
Literature
1.
go back to reference Hengartner H, Berger C, Nadal D et al (2004) Port-A-Cath infections in children with cancer. Eur J Cancer 40:2452–2458PubMedCrossRef Hengartner H, Berger C, Nadal D et al (2004) Port-A-Cath infections in children with cancer. Eur J Cancer 40:2452–2458PubMedCrossRef
2.
go back to reference Simon A, Bode U, Beutel K (2006) Diagnosis and treatment of catheter-related infections in pediatric oncology, an update. Clin Microbiol Infect 12:606–620PubMedCrossRef Simon A, Bode U, Beutel K (2006) Diagnosis and treatment of catheter-related infections in pediatric oncology, an update. Clin Microbiol Infect 12:606–620PubMedCrossRef
3.
go back to reference Niederhuber JE, Ensminger W, Gyves JW et al (1982) Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 92:706–712PubMed Niederhuber JE, Ensminger W, Gyves JW et al (1982) Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 92:706–712PubMed
4.
5.
go back to reference Wu JR, Hsu JH, Chang TT et al (2002) Nonsurgical percutaneous retrieval of dislodged port-A catheters from pulmonary artery in children. Jpn Heart J 43:295–300PubMedCrossRef Wu JR, Hsu JH, Chang TT et al (2002) Nonsurgical percutaneous retrieval of dislodged port-A catheters from pulmonary artery in children. Jpn Heart J 43:295–300PubMedCrossRef
6.
go back to reference Coit DG, Turnbull AD (1988) A safe technique for placement of implantable vascular access devices in patients with thrombocytopenia. Surg Gynecol Oncol 14:63–68 Coit DG, Turnbull AD (1988) A safe technique for placement of implantable vascular access devices in patients with thrombocytopenia. Surg Gynecol Oncol 14:63–68
7.
go back to reference Moureau N, Poole S, Murdock MA et al (2002) Central venous catheters in home infusion care: outcomes analysis in 50, 470 patients. J Vasc Interv Radiol 13:1009–1016PubMedCrossRef Moureau N, Poole S, Murdock MA et al (2002) Central venous catheters in home infusion care: outcomes analysis in 50, 470 patients. J Vasc Interv Radiol 13:1009–1016PubMedCrossRef
8.
go back to reference Liu JC, Tseng HS, Chen CY et al (2004) Percutaneous retrieval of 20 centrally dislodged port-A catheter fragments. Clin Imaging 28:223–229PubMedCrossRef Liu JC, Tseng HS, Chen CY et al (2004) Percutaneous retrieval of 20 centrally dislodged port-A catheter fragments. Clin Imaging 28:223–229PubMedCrossRef
9.
go back to reference Grabenwoeger F, Bardach G, Dock W et al (1988) Percutaneous extraction of centrally embolized foreign bodies: a report of 16 cases. Br J Radiol 61:1014–1018PubMedCrossRef Grabenwoeger F, Bardach G, Dock W et al (1988) Percutaneous extraction of centrally embolized foreign bodies: a report of 16 cases. Br J Radiol 61:1014–1018PubMedCrossRef
10.
go back to reference Fisher RG, Ferreyro R (1978) Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies. AJR Am J Roentgenol 130:541–548PubMed Fisher RG, Ferreyro R (1978) Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies. AJR Am J Roentgenol 130:541–548PubMed
11.
go back to reference Coles CE, Whitear WP, LeVay JH (1998) Spontaneous fracture and embolization of a central venous catheter: prevention and early detection. Clin Oncol 10:412–414CrossRef Coles CE, Whitear WP, LeVay JH (1998) Spontaneous fracture and embolization of a central venous catheter: prevention and early detection. Clin Oncol 10:412–414CrossRef
12.
go back to reference Teichgräber UK, Gebauer B, Benter T et al (2003) Central venous access catheters: radiological management of complications. Cardiovasc Intervent Radiol 26:321–333PubMedCrossRef Teichgräber UK, Gebauer B, Benter T et al (2003) Central venous access catheters: radiological management of complications. Cardiovasc Intervent Radiol 26:321–333PubMedCrossRef
13.
go back to reference Bloomfield DA (1971) Techniques of nonsurgical retrieval of iatrogenic foreign bodies from the heart. Am J Cardiol 27:538–545PubMedCrossRef Bloomfield DA (1971) Techniques of nonsurgical retrieval of iatrogenic foreign bodies from the heart. Am J Cardiol 27:538–545PubMedCrossRef
14.
go back to reference Aitken DR, Minton JP (1984) The “pinch-off sign”: a warning of impending problems with permanent subclavian catheters. Am J Surg 148:633–636PubMedCrossRef Aitken DR, Minton JP (1984) The “pinch-off sign”: a warning of impending problems with permanent subclavian catheters. Am J Surg 148:633–636PubMedCrossRef
15.
go back to reference Yu SY, Lee CH, Ko PJ et al (2009) Use of stone basket for removal of fractured totally implanted central venous device catheters. Formos J Surg 42:87–94 Yu SY, Lee CH, Ko PJ et al (2009) Use of stone basket for removal of fractured totally implanted central venous device catheters. Formos J Surg 42:87–94
Metadata
Title
Catheter Fracture of Intravenous Ports and its Management
Authors
Ching-Yang Wu
Jui-Ying Fu
Po-Hao Feng
Tsung-Chi Kao
Sheng-Yueh Yu
Hao-Jui Li
Po-Jen Ko
Hung-Chang Hsieh
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 11/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1200-x

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