Placement of an Implantable Central Venous Access Device

ABSTRACT

PURPOSE: To evaluate the efficacy and safety of placement of a central venous catheter with infusion portinto the superior vena cava MATERIALS & METHODS: Central venous catheters with a infusion port were implanted in21 patients (MF=417, age range15-63, mean age41) diagnosed as suffering from breast cancer(n=9),lymphoma(n=7), thymoma(n=2) rhabdomyosarcoma(n=2) and rectal cancer(n=1). The peripheral portion of the subclaveanvein was punctured under fluoroscopic guidance during injection of contrast media at the site of the ipsilateralperipheral vein (20 cases) and under ultrasonographic guidance (1 case). 9.6F central venous catheters placed inthe superior vena cava via the subclavian vein and the connected infusion ports were implanted in the subcutaneouspocket near the puncture site of the right anterosuperior chest wall. RESULTS: Catheter insertion in the superiorvena cava and port implantation in the subcutaneous pocket were successful in all patients. Mean procedure timewas 23 minutes and there were no early complications. Because the incision site had not healed, one patientunderwent resuturing 3 weeks after the procedure. In one case, thrombotic occlusion of the catheter occurred, butsuccessful recanalization, involving urokinase infusion, was performed. At the end of the chemotherapy schedule,at 180, 157 and 139 days after the procedure, three central venous catheters with a infusion port were removed inthe radiologic suite. Catheter days are 5 days-180 days(mean, 119) from now (1997. 7. 1). CONCLUSIONS: Radiologicplacement under fluoroscopic guidance of a central venous catheter with a infusion port is easy, safe and usefulfor patients requring long-term venous access.