Safety on catheter malposition of implantable venous access port

doi:10.3877/cma.j.issn.1674-0807.2017.02.005

Abstract

Abstract:

Objective

To investigate the incidence of catheter malposition in breast cancer patients with implantable venous access port (IVAP) and explore the safety.

Methods

We retrospectively analyzed the data of 360 breast cancer patients receiving chemotherapy via IVAP in Department of Endocrine and Breast Surgery, First Affiliated Hospital, Chongqing Medical University from June 2015 to March 2016. The catheter malposition of IVAP in left and right internal jugular vein catheterization was investigated. The IVAP-related thrombosis in those patients with catheter malposition was recorded. χ² test and Fisher exact test were used to compare the rates of catheter malposition of IVAP.

Results

Totally 360 patients had successful catheterization via internal jugular veins under the guidance of ultrasound, including 139 patients via the left internal jugular vein and 221 patients via the right internal jugular vein. However,postoperative chest X-ray revealed in 5 cases and the catheter located in superior vena cava in 355 cases. The catheter malposition was located in ipsilateral internal jugular vein (2 patients), ipsilateral subclavian vein (2 patients) or contralateral innominate vein(1 patient) on the chest radiograph. The incidence of catheter malposition of IVAP was 1.4% (5/360). The incidence of catheter malposition was 2.2% (3/139) for left internal jugular vein and 0.9% (2/221) for right internal jugular vein, indicating a significant difference (χ² = 0.277, P = 0.598). Five patients had asymptomatic IVAP-related thrombosis. Blood could be pumpbacked via IVAP and the transfusion was fluent.No patients had discomfort caused by catheter malposition. All patients were closely followed up without any special treatment. IVAP was successfully removed after chemotherapy. The median catheterization duration was 156 d (range:135-182 d).

Conclusions

Application of IVAP in breast cancer patients during chemotherapy is safe and effective. The incidence of catheter malposition is low, even in catheter malposition, continuous application of IVAP is safe under close monitoring.

Key words: Breast neoplasms; Catheterization, central venous; Infusions, intravenous;Catheters, indwelling; Catheter malposition

Lei Xing, Hong Liu, Guo Shi, Feng Luo, Guosheng Ren. Safety on catheter malposition of implantable venous access port[J]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(02): 83-86.

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References 12

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