Assessement of the complications of Ultrasound and Fluoroscopy-Guided Placement of Totally implantable venous access ports

INTRODUCTION: Totally implantable venous access systems are widely used in oncology; however, their complications are extremely common which, sometimes, require device removal, thereby, leading to delayed chemotherapy and infusion therapies. In this study, we aimed to investigate the immediate, early, and late complications of venous port implantation in our oncology patients.
METHODS: A total of 219 consecutive cancer patients (111 males, 108 females; mean age: 56.9 years; range: 1 to 81 years) were retrospectively analyzed between January 2013 and June 2014. A total of 220 ultrasound- and fluoroscopy-guided totally implantable venous port systems were implanted through the right or left internal jugular vein access.
RESULTS: The mean follow-up was 83.7 (range: 2 to 410) days. Overall complication rate was 8.6% (19/220). Eight devices in seven patients were removed due to complications. Two ports were removed in one patient. The complications which required port removal were compromised port-related bloodstream infection (n=5), central venous thrombosis (n=3), and catheter thrombosis (n=1). No major complication or no mortality associated with the port implantation was seen during follow-up. Totally seven immediate complications including local hematoma (n=2), catheter tip retraction (n=2), pain (n=1), catheter loop formation (n=1), catheter malposition (n=1), two early complications (n=2; 1 wound dehiscence, and 1 wound infection), and 10 late complications including catheter-related blood stream infection (n=5), central venous thrombosis (n=3), catheter thrombosis (n=1), and tunnel hematoma (n=1) occurred.
DISCUSSION AND CONCLUSION: Low incidence of complications suggest ultrasound- and fluoroscopy-guided venous port implantation is a safe and reliable method for long-term venous access.