Use of totally implantable central venous access ports for high-dose chemotherapy and peripheral blood stem cell transplantation: results of a monocentre series of 376 patients
Open Access
- 1 February 2004
- journal article
- clinical trial
- Published by Elsevier BV in Annals of Oncology
- Vol. 15 (2), 296-300
- https://doi.org/10.1093/annonc/mdh049
Abstract
Background: The complication rate of central venous totally implantable access ports (TIAP), used for high-dose chemotherapy with autologous stem cell transplantation support, has not been fully investigated to date, due to the almost exclusive use of externalised, tunnelled devices in this clinical setting. Patients and methods: During a 66-month period (from 1 January 1997 to 30 June 2002), 376 patients suffering from breast cancer, ovarian cancer, lymphoma or multiple myeloma were treated with high-dose chemotherapy and autologous stem cell transplantation at the European Institute of Oncology (Milan, Italy). A single type of port was used, constructed from titanium and silicone rubber, connected to a 7.8 F polyurethane catheter (Port-A-Cath™; SIMS Deltec, Inc., St Paul, MN, USA) inserted into the subclavian vein. They were followed prospectively for device-related complications until the device was removed, the patient died or the study was closed (30 June 2002). Results: No TIAP-related deaths were observed in this series. Seven pneumothoraxes (1.8%) occurred as a complication of TIAP placement, one patient only (0.2%) requiring a tube thoracostomy. Port pocket infection occurred twice in this series (0.53%, 0.01 episodes/1000 days of use), whereas three patients suffered from port-related bacteraemia (0.8%, 0.016/1000 days of use). Infections were successfully treated with antibiotics; all three cases had the ports removed at programme completion. Four cases of deep vein thrombosis were detected (1.06%, 0.022/1000 days of use); low molecular weight heparin was given, followed by oral anticoagulants. Finally, one case of extravasation occurred (0.26%, 0.005/1000 days of use), requiring port removal and local medical therapy. Conclusions: The use of TIAPs has resulted in a safe and effective option for high-dose chemotherapy deliverance and stem cell transplantation, in spite of inducing severe neutropenia and increasing the risk of sepsis in this category of oncology patient.This publication has 20 references indexed in Scilit:
- 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 deviceBone Marrow Transplantation, 1999
- Totally implantable central venous access ports for long-term chemotherapy A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 daysAnnals of Oncology, 1998
- Increased Incidence of Central Venous Catheter-Related Infections in Bone Marrow Transplant PatientsAmerican Journal of Clinical Oncology, 1995
- Results of antibiotic treatment of Hickman-catheter-related infections in oncological patientsSupportive Care in Cancer, 1994
- Infectious Morbidity Associated with Long-Term Use of Venous Access Devices in Patients with CancerAnnals of Internal Medicine, 1993
- Low Infection Rate and Long Durability of Nontunneled Silastic CathetersArchives of Internal Medicine, 1993
- A prospective randomized trial comparing the infectious and noninfectious complications of an externalized catheter versus a subcutaneously implanted device in cancer patients.Journal of Clinical Oncology, 1992
- Nosocomial septicemia in the cancer patient: The influence of central venous access devices, neutropenia, and type of malignancyMedical and Pediatric Oncology, 1990
- Comparison of a Totally Implantable Access Device for Chemotherapy (Port-A-Cath) and Long-term Percutaneous Catheterization (Broviac)*Southern Medical Journal, 1988
- Reliability of Implantable Central Venous Access Devices in Patients With CancerArchives of Surgery, 1987