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Published in: International Journal of Clinical Oncology 3/2016

Open Access 01-06-2016 | Original Article

A retrospective analysis on the utility and complications of upper arm ports in 433 cases at a single institute

Authors: Yukiko Mori, Satoshi Nagayama, Jun-ichiro Kawamura, Suguru Hasegawa, Eiji Tanaka, Hiroshi Okabe, Megumi Takeuchi, Makoto Sonobe, Shigemi Matsumoto, Masashi Kanai, Manabu Muto, Tsutomu Chiba, Yoshiharu Sakai

Published in: International Journal of Clinical Oncology | Issue 3/2016

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Abstract

Background

We have employed upper arm central venous ports (UACVPs) since 2006 for long-term intravenous chemotherapy (CTx) or fluid supplementation. We evaluated the long-term availability of CVPs implanted in the upper arm to determine whether UACVPs could be one of the treatment options besides chest CVPs in terms of CVP-related complications.

Methods

We reviewed the medical records of all patients who underwent subcutaneous implantation of UACVPs at Kyoto University Hospital from 1 April, 2006 to 30 June, 2009. We assessed the indwelling duration of the UACVPs and the incidences of early and late UACVP-related complications.

Results

A total of 433 patients underwent subcutaneous implantation of UACVPs during this time period. The cumulative follow-up period was 251,538 catheter days, and the median duration of UACVP indwelling was 439.0 days (1–2, 24). There was no UACVP-related mortality throughout the study period. A total of 83 UACVP-related complications occurred (19.2 %), including 43 cases of infection (9.9 %, 0.17/1000 catheter days), ten cases of catheter-related thrombosis (2.3 %, 0.040/1000 catheter days), ten cases of occlusion (2.3 %, 0.040/1000 catheter days), nine cases of catheter dislocation (2.0 %, 0.036/1000 catheter days), five cases of port leakage (1.2 %, 0.019/1000 catheter days), four cases of skin dehiscence (0.9 %, 0.015/1000 catheter days) and two cases of port chamber twist (0.5 %, 0.008/1000 catheter days). The removal-free one-year port availability was estimated at 87.8 %.

Conclusions

UACVPs were of long-term utility, with complication rates comparable to those of chest CVPs previously reported.
Literature
1.
go back to reference Engstrom PF, Arnoletti JP, Benson AB 3rd et al (2009) NCCN Clinical practice guidelines in oncology: colon cancer. J Natl Compr Canc Netw 7:778–831PubMed Engstrom PF, Arnoletti JP, Benson AB 3rd et al (2009) NCCN Clinical practice guidelines in oncology: colon cancer. J Natl Compr Canc Netw 7:778–831PubMed
2.
go back to reference Engstrom PF, Arnoletti JP, Benson AB 3rd et al (2009) NCCN Clinical Practice Guidelines in Oncology: rectal cancer. J Natl Compr Canc Netw 7:838–881PubMed Engstrom PF, Arnoletti JP, Benson AB 3rd et al (2009) NCCN Clinical Practice Guidelines in Oncology: rectal cancer. J Natl Compr Canc Netw 7:838–881PubMed
3.
go back to reference Benson AB 3rd, Bekaii-Saab T, Chan E et al (2013) Metastatic colon cancer, version 3.2013: featured updates to the NCCN Guidelines. J Natl Compr Canc Netw 11(2):141–152PubMed Benson AB 3rd, Bekaii-Saab T, Chan E et al (2013) Metastatic colon cancer, version 3.2013: featured updates to the NCCN Guidelines. J Natl Compr Canc Netw 11(2):141–152PubMed
4.
go back to reference Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364(19):1817–1825CrossRefPubMed Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364(19):1817–1825CrossRefPubMed
5.
go back to reference Di Carlo I, Cordio S, La Greca G et al (2001) Totally implantable venous access devices implanted surgically: a retrospective study on early and late complications. Arch Surg 136:1050–1053CrossRefPubMed Di Carlo I, Cordio S, La Greca G et al (2001) Totally implantable venous access devices implanted surgically: a retrospective study on early and late complications. Arch Surg 136:1050–1053CrossRefPubMed
6.
go back to reference Lorch H, Zwaan M, Kagel C et al (2001) Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol 24:180–184CrossRefPubMed Lorch H, Zwaan M, Kagel C et al (2001) Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol 24:180–184CrossRefPubMed
7.
go back to reference Damascelli B, Patelli G, Frigerio LF et al (1997) Placement of long-term central venous catheters in outpatients: study of 134 patients over 24 596 catheter-days. Am J Roentgenol 168:1235–1239CrossRef Damascelli B, Patelli G, Frigerio LF et al (1997) Placement of long-term central venous catheters in outpatients: study of 134 patients over 24 596 catheter-days. Am J Roentgenol 168:1235–1239CrossRef
8.
go back to reference Sakamoto N, Arai Y, Takeuchi Y et al (2010) Ultrasound-guided radiological placement of central venous port via the subclavian vein: a retrospective analysis of 500 cases at a single institute. Cardiovasc Intervent Radiol 33:989–994CrossRefPubMed Sakamoto N, Arai Y, Takeuchi Y et al (2010) Ultrasound-guided radiological placement of central venous port via the subclavian vein: a retrospective analysis of 500 cases at a single institute. Cardiovasc Intervent Radiol 33:989–994CrossRefPubMed
9.
go back to reference Hinke DH, Zandt-Stastny DA, Goodman LR et al (1990) Pinchoff syndrome: a complication of implantable subclavian venous access devices. Radiology 177:353–356CrossRefPubMed Hinke DH, Zandt-Stastny DA, Goodman LR et al (1990) Pinchoff syndrome: a complication of implantable subclavian venous access devices. Radiology 177:353–356CrossRefPubMed
10.
go back to reference Klotz HP, Schöpke W, Kohler A et al (1996) Catheter fracture: a rare complication of totally implantable subclavian venous access devices. J Surg Oncol 62:222–225CrossRefPubMed Klotz HP, Schöpke W, Kohler A et al (1996) Catheter fracture: a rare complication of totally implantable subclavian venous access devices. J Surg Oncol 62:222–225CrossRefPubMed
11.
go back to reference Mirza B, Vanek VW, Kupensky DT (2004) Pinch-off syndrome: case report and collective review of the literature. Am Surg 70:635–644PubMed Mirza B, Vanek VW, Kupensky DT (2004) Pinch-off syndrome: case report and collective review of the literature. Am Surg 70:635–644PubMed
12.
go back to reference Pittiruti M, Malerba M, Carriero C et al (2000) Which is the easiest and safest technique for central venous access? A retrospective survey of more than 5400 cases. J Vasc Access 1:100–107PubMed Pittiruti M, Malerba M, Carriero C et al (2000) Which is the easiest and safest technique for central venous access? A retrospective survey of more than 5400 cases. J Vasc Access 1:100–107PubMed
13.
go back to reference Schuman E, Brady A, Gross G et al (1987) Vascular access options for outpatient cancer therapy. Am J Surg 153:487–489CrossRefPubMed Schuman E, Brady A, Gross G et al (1987) Vascular access options for outpatient cancer therapy. Am J Surg 153:487–489CrossRefPubMed
14.
go back to reference Teichgräber UK, Kausche S, Nagel SN et al (2011) Outcome analysis in 3160 implantations of radiologically guided placements of totally implantable central venous port systems. Eur Radiol 21:1224–1232CrossRefPubMed Teichgräber UK, Kausche S, Nagel SN et al (2011) Outcome analysis in 3160 implantations of radiologically guided placements of totally implantable central venous port systems. Eur Radiol 21:1224–1232CrossRefPubMed
15.
go back to reference Sofocleous CT, Schur I, Cooper SG et al (1998) Sonographically guided placement of peripherally inserted central venous catheters: review of 355 procedures. Am J Roentgenol 170:1613–1616CrossRef Sofocleous CT, Schur I, Cooper SG et al (1998) Sonographically guided placement of peripherally inserted central venous catheters: review of 355 procedures. Am J Roentgenol 170:1613–1616CrossRef
16.
go back to reference Marcy PY, Figl A, Amoretti N et al (2010) Arm port implantation in cancer patients. Int J Clin Oncol 15:328–330CrossRefPubMed Marcy PY, Figl A, Amoretti N et al (2010) Arm port implantation in cancer patients. Int J Clin Oncol 15:328–330CrossRefPubMed
17.
go back to reference Marcy PY, Magné N, Castadot P et al (2007) Is radiologic placement of an arm port mandatory in oncology patients: analysis of a large bi-institutional experience. Cancer 110:2331–2338CrossRefPubMed Marcy PY, Magné N, Castadot P et al (2007) Is radiologic placement of an arm port mandatory in oncology patients: analysis of a large bi-institutional experience. Cancer 110:2331–2338CrossRefPubMed
18.
go back to reference Kawamura J, Nagayama S, Nomura A et al (2008) Long-term outcomes of peripheral arm ports implanted in patients with colorectal cancer. Int J Clin Oncol 13:349–354CrossRefPubMed Kawamura J, Nagayama S, Nomura A et al (2008) Long-term outcomes of peripheral arm ports implanted in patients with colorectal cancer. Int J Clin Oncol 13:349–354CrossRefPubMed
19.
go back to reference Shetty PC, Mody MK, Kastan DJ et al (1997) Outcome of 350 implanted chest ports placed by interventional radiologists. J Vasc Interv Radiol 8:991–995CrossRefPubMed Shetty PC, Mody MK, Kastan DJ et al (1997) Outcome of 350 implanted chest ports placed by interventional radiologists. J Vasc Interv Radiol 8:991–995CrossRefPubMed
20.
go back to reference Funaki B, Szymski GX, Hackworth CA et al (1997) Radiologic placement of subcutaneous infusion chest ports for long-time central venous access. Am J Roentgenol 169:1431–1434CrossRef Funaki B, Szymski GX, Hackworth CA et al (1997) Radiologic placement of subcutaneous infusion chest ports for long-time central venous access. Am J Roentgenol 169:1431–1434CrossRef
21.
go back to reference Koch HJ, Pietsch M, Krause U et al (1998) Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port systems. World J Surg 22:12–16CrossRef Koch HJ, Pietsch M, Krause U et al (1998) Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port systems. World J Surg 22:12–16CrossRef
22.
go back to reference Biffi R, Martinelli G, Pozzi S et al (1999) Totally implantable central venous access ports for high-dose chemotherapy administration and autologous stem cell transplantation: analysis of overall and septic complications in 68 cases using a single type of device. Bone Marrow Transplant 24:89–93CrossRefPubMed Biffi R, Martinelli G, Pozzi S et al (1999) Totally implantable central venous access ports for high-dose chemotherapy administration and autologous stem cell transplantation: analysis of overall and septic complications in 68 cases using a single type of device. Bone Marrow Transplant 24:89–93CrossRefPubMed
23.
go back to reference Deppe G, Kahn ML, Malviya VK et al (1996) Experience with the P.A.S.-PORT venous access device in patients with gynecologic malignancies. Gynecol Oncol 62:340–343CrossRefPubMed Deppe G, Kahn ML, Malviya VK et al (1996) Experience with the P.A.S.-PORT venous access device in patients with gynecologic malignancies. Gynecol Oncol 62:340–343CrossRefPubMed
24.
go back to reference Hata Y, Morita S, Morita Y et al (1998) Peripheral insertion of a central venous access device under fl uoroscopic guidance using a peripherally accessed system (PAS) port in the forearm. Cardiovasc Intervent Radiol 21:230–233CrossRefPubMed Hata Y, Morita S, Morita Y et al (1998) Peripheral insertion of a central venous access device under fl uoroscopic guidance using a peripherally accessed system (PAS) port in the forearm. Cardiovasc Intervent Radiol 21:230–233CrossRefPubMed
25.
go back to reference Bodner LJ, Nosher JL, Patel KM et al (2000) Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol 23:187–193CrossRefPubMed Bodner LJ, Nosher JL, Patel KM et al (2000) Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol 23:187–193CrossRefPubMed
26.
go back to reference Burbridge B, Krieger E, Stoneham G (2000) Arm placement of the cook titanium petite vital-port: results of radiologic placement in 125 patients with cancer. Can Assoc Radiol J 51:163–169PubMed Burbridge B, Krieger E, Stoneham G (2000) Arm placement of the cook titanium petite vital-port: results of radiologic placement in 125 patients with cancer. Can Assoc Radiol J 51:163–169PubMed
27.
go back to reference Tsuboi N, Morita S, Yamanishi T et al (2003) Long-Term outcomes of a totally implantable central venous access system in the forearm. Jpn J Intervent Radiol 18:43–48 Tsuboi N, Morita S, Yamanishi T et al (2003) Long-Term outcomes of a totally implantable central venous access system in the forearm. Jpn J Intervent Radiol 18:43–48
28.
go back to reference Vescia S, Baumagartner AK, Jacobs VR et al (2008) Management of venous port systems in oncology: a review of current evidence. Ann Oncol 19:9–15CrossRefPubMed Vescia S, Baumagartner AK, Jacobs VR et al (2008) Management of venous port systems in oncology: a review of current evidence. Ann Oncol 19:9–15CrossRefPubMed
29.
go back to reference Kuriakose P, Colon-Otero G, Paz-Fumagalli R (2002) Risk of deep venous thrombosis associated with chest versus arm central venous subcutaneous port catheters: a 5 years single-institution retrospective study. J Vasc Interv Radiol 13:179–184CrossRefPubMed Kuriakose P, Colon-Otero G, Paz-Fumagalli R (2002) Risk of deep venous thrombosis associated with chest versus arm central venous subcutaneous port catheters: a 5 years single-institution retrospective study. J Vasc Interv Radiol 13:179–184CrossRefPubMed
30.
go back to reference Marcy PY, Chamorey E, Amoretti N et al (2008) A comparison between distal and proximal port device insertion in head and neck cancer. Eur J Surg Oncol 34:1262–1269CrossRefPubMed Marcy PY, Chamorey E, Amoretti N et al (2008) A comparison between distal and proximal port device insertion in head and neck cancer. Eur J Surg Oncol 34:1262–1269CrossRefPubMed
31.
go back to reference Marcy PY, Magné N, Castadot P et al (2005) Radiological and surgical placement of port devices: a 4 years institutional analysis of procedure performance, quality of life and cost in breast cancer patients. Breast Cancer Res Treat 92:61–67CrossRefPubMed Marcy PY, Magné N, Castadot P et al (2005) Radiological and surgical placement of port devices: a 4 years institutional analysis of procedure performance, quality of life and cost in breast cancer patients. Breast Cancer Res Treat 92:61–67CrossRefPubMed
32.
go back to reference Debourdeau P, Kassab Chahmi D, Le Gal G et al (2008) SOR guidelines for the prevention and treatment of thrombosis associated with central venous catheters in patients with cancer: report from the working group. Ann Oncol 2009(20):1459–1471 Debourdeau P, Kassab Chahmi D, Le Gal G et al (2008) SOR guidelines for the prevention and treatment of thrombosis associated with central venous catheters in patients with cancer: report from the working group. Ann Oncol 2009(20):1459–1471
33.
go back to reference Khorana AA, Streiff MB, Farge D et al (2009) Venous thromboembolism prophylaxis and treatment in cancer: a consensus statement of major guidelines panels and call to action. J Clin Oncol 27:4919–4926CrossRefPubMedPubMedCentral Khorana AA, Streiff MB, Farge D et al (2009) Venous thromboembolism prophylaxis and treatment in cancer: a consensus statement of major guidelines panels and call to action. J Clin Oncol 27:4919–4926CrossRefPubMedPubMedCentral
34.
go back to reference Heit JA, Silverstein MD, Mohr DN et al (2000) Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med 160:809–815CrossRefPubMed Heit JA, Silverstein MD, Mohr DN et al (2000) Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med 160:809–815CrossRefPubMed
35.
go back to reference Silverstein MD, Heit JA, Mohr DN et al (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25 years population-based study. Arch Intern Med 158:585–593CrossRefPubMed Silverstein MD, Heit JA, Mohr DN et al (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25 years population-based study. Arch Intern Med 158:585–593CrossRefPubMed
36.
go back to reference Luciani A, Clement O, Halimi P et al (2001) Catheter-related upper extremity deep venous thrombosis in cancer patients: a prospective study based on Doppler US. Radiology 220:655–660CrossRefPubMed Luciani A, Clement O, Halimi P et al (2001) Catheter-related upper extremity deep venous thrombosis in cancer patients: a prospective study based on Doppler US. Radiology 220:655–660CrossRefPubMed
37.
go back to reference Hurwitz HI, Saltz LB, Cutsem EV et al (2011) Venous thromboembolic events with chemotherapy plus bevacizumab: a pooled analysis of patients in randomized phase II and III studies. J Clin Oncol 29:1757–1764CrossRefPubMed Hurwitz HI, Saltz LB, Cutsem EV et al (2011) Venous thromboembolic events with chemotherapy plus bevacizumab: a pooled analysis of patients in randomized phase II and III studies. J Clin Oncol 29:1757–1764CrossRefPubMed
Metadata
Title
A retrospective analysis on the utility and complications of upper arm ports in 433 cases at a single institute
Authors
Yukiko Mori
Satoshi Nagayama
Jun-ichiro Kawamura
Suguru Hasegawa
Eiji Tanaka
Hiroshi Okabe
Megumi Takeuchi
Makoto Sonobe
Shigemi Matsumoto
Masashi Kanai
Manabu Muto
Tsutomu Chiba
Yoshiharu Sakai
Publication date
01-06-2016
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 3/2016
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-015-0917-1

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