Abstract

Background: Regardless of the fact that we often perform totally implantable venous-access ports (TIVAPs) for cancer chemotherapy, there have been several reports regarding complications of its use in the world. The objective of this study was to summarize the TIVAPs idiopathic complications of 400 cancer chemotherapy patients in latest 6 years. The patients underwent TIVAPs in the internal jugular or subclavian vein via the seldinger techniqueunder fluoroscopic control by surgeon.We used two different devices, which were the Bard X-Port™, used from 2009 to 2012, and the Power Port™ used from 2012 to present. These devices are composed of titanium and silicone rubber port (DomePort™, Bard Inc., Salt Lake City, UT, USA) connected to an 8Fr silasticGroshong™ catheter tube.
Results: Four hundred fourdevices in 400 patients, a total of 121,856 days’ insertions, with a median follow up of 388 days. There were 30 idiopathic complications. The total complication rate was 7.5% (30/400). The early complication rate was 0.75% (3/400) which reason was pneumothorax under the seldinger technique even used ultrasonic machine. The late complications consisted of eleven complete occlusions (2.75%), eight pocket infections (2%), three of pneumothorax (0.75%), two pinch-off (0.5%), two slip-off due to pedunculated breast (0.5%), one catheter-related bacteremia (0.25%), one wound dehiscence due to bevacizumab™ (0.25%), one rubber port disconnection (0.25%), and one rubber port rotation (0.25%) in pocket. Especially, we experienced 12cm length red thrombus and elevated D-dimer which possibility triggered Trousseau syndrome in parallel.
Conclusion: Although there were only 7.5% (30/400) catheter-related complications with these TIVAPs, justifying its use, we have to be careful with complications such as a pinch-off, slip-off, infection, disconnection and occlusion.