Complications of subcutaneous infusion port in the general oncology population

Carlo Ballarini, M. Intra, A. Pisani Ceretti, A. Cordovana, M. Pagani, G. Farina, S. Perrone, M. Tomirotti, A. Scanni, G. P. Spina

Research output: Contribution to journalArticle

Abstract

Subcutaneous infusion ports (SIPs) represent a valid method for long-term chemotherapy. The SIPs have several advantages over other methods of venous access: they are easy to implant under local anaesthesia, have less discomfort for the patients, allow low costs, can be implanted in day hospital, and can be managed ambulatorily. However, SIPs have delayed complications, frequently related to clinical conditions of the neoplastic patients, and immediate complications, often due to the placement technique. From March 1992 to March 1997 we placed, under local anaesthesia and under fluoroscopic control, 102 SIPs in 99 general oncology patients for long-term chemotherapy (88% solid, 12% haematological tumours). The percutaneous venous access devices were in the subclavian vein in 96% of the cases and in the internal jugular vein in 4% of them. immediate complications were: 1 haemopneumothorax, which required thoracic aspirations and two blood transfusions, 1 loop of the tunneled part of the catheter without alterations in SIP function, and 1 left jugular thrombosis in a patient with subclavian veins already thrombosed. The venous access was in the subclavian vein in the first 2 cases, and it was not necessary to suspend the therapeutic program. In the third instance, implanted in jugular vein, it was necessary to remove the SIP. Delayed complications were: 1 necrosis of the skin over the port, 1 infection of subcutaneous pocket, 2 infections of the system, 1 catheter deconnection, and 3 catheter ruptures with embolization of the catheter tip. The SIPs were removed in all cases but 1 in whom infection was successfully treated by appropriate antibiotic therapy. Embolization of the catheter required removal from the pulmonary artery under fluoroscopic guidance in the cardiac catheterization laboratory. In conclusion, infection and thrombosis are the two major complications of SIP in general oncology patients. In these cases it is not necessary to remove systematically the system, but a correct therapy (antibiotic, fibrinolytic agents) can be utilized with good results. The catheter rupture is often due to the wear over the costoclavicular angle. The interventional radiology is the method of choice in the treatment of the catheter embolization by rupture or dislocation. The experience of the surgical and nursing staff is probably the most important factor in decreasing the total rate of complications.

Original languageEnglish
Pages (from-to)97-102
Number of pages6
JournalOncology
Volume56
Issue number2
DOIs
Publication statusPublished - Feb 1999

Fingerprint

Subcutaneous Infusions
Catheters
Subclavian Vein
Population
Rupture
Thrombosis
Jugular Veins
Local Anesthesia
Infection
Hemopneumothorax
Perioperative Nursing
Anti-Bacterial Agents
Drug Therapy
Interventional Radiology
Fibrinolytic Agents
Nursing Staff
Therapeutics
Cardiac Catheterization
Blood Transfusion
Pulmonary Artery

Keywords

  • Central venous catheter, complications
  • Port-A-Cath
  • Subcutaneous infusion port

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ballarini, C., Intra, M., Pisani Ceretti, A., Cordovana, A., Pagani, M., Farina, G., ... Spina, G. P. (1999). Complications of subcutaneous infusion port in the general oncology population. Oncology, 56(2), 97-102. https://doi.org/10.1159/000011947

Complications of subcutaneous infusion port in the general oncology population. / Ballarini, Carlo; Intra, M.; Pisani Ceretti, A.; Cordovana, A.; Pagani, M.; Farina, G.; Perrone, S.; Tomirotti, M.; Scanni, A.; Spina, G. P.

In: Oncology, Vol. 56, No. 2, 02.1999, p. 97-102.

Research output: Contribution to journalArticle

Ballarini, C, Intra, M, Pisani Ceretti, A, Cordovana, A, Pagani, M, Farina, G, Perrone, S, Tomirotti, M, Scanni, A & Spina, GP 1999, 'Complications of subcutaneous infusion port in the general oncology population', Oncology, vol. 56, no. 2, pp. 97-102. https://doi.org/10.1159/000011947
Ballarini C, Intra M, Pisani Ceretti A, Cordovana A, Pagani M, Farina G et al. Complications of subcutaneous infusion port in the general oncology population. Oncology. 1999 Feb;56(2):97-102. https://doi.org/10.1159/000011947
Ballarini, Carlo ; Intra, M. ; Pisani Ceretti, A. ; Cordovana, A. ; Pagani, M. ; Farina, G. ; Perrone, S. ; Tomirotti, M. ; Scanni, A. ; Spina, G. P. / Complications of subcutaneous infusion port in the general oncology population. In: Oncology. 1999 ; Vol. 56, No. 2. pp. 97-102.
@article{18fcf8f81085458dab5d4014fb8c07db,
title = "Complications of subcutaneous infusion port in the general oncology population",
abstract = "Subcutaneous infusion ports (SIPs) represent a valid method for long-term chemotherapy. The SIPs have several advantages over other methods of venous access: they are easy to implant under local anaesthesia, have less discomfort for the patients, allow low costs, can be implanted in day hospital, and can be managed ambulatorily. However, SIPs have delayed complications, frequently related to clinical conditions of the neoplastic patients, and immediate complications, often due to the placement technique. From March 1992 to March 1997 we placed, under local anaesthesia and under fluoroscopic control, 102 SIPs in 99 general oncology patients for long-term chemotherapy (88{\%} solid, 12{\%} haematological tumours). The percutaneous venous access devices were in the subclavian vein in 96{\%} of the cases and in the internal jugular vein in 4{\%} of them. immediate complications were: 1 haemopneumothorax, which required thoracic aspirations and two blood transfusions, 1 loop of the tunneled part of the catheter without alterations in SIP function, and 1 left jugular thrombosis in a patient with subclavian veins already thrombosed. The venous access was in the subclavian vein in the first 2 cases, and it was not necessary to suspend the therapeutic program. In the third instance, implanted in jugular vein, it was necessary to remove the SIP. Delayed complications were: 1 necrosis of the skin over the port, 1 infection of subcutaneous pocket, 2 infections of the system, 1 catheter deconnection, and 3 catheter ruptures with embolization of the catheter tip. The SIPs were removed in all cases but 1 in whom infection was successfully treated by appropriate antibiotic therapy. Embolization of the catheter required removal from the pulmonary artery under fluoroscopic guidance in the cardiac catheterization laboratory. In conclusion, infection and thrombosis are the two major complications of SIP in general oncology patients. In these cases it is not necessary to remove systematically the system, but a correct therapy (antibiotic, fibrinolytic agents) can be utilized with good results. The catheter rupture is often due to the wear over the costoclavicular angle. The interventional radiology is the method of choice in the treatment of the catheter embolization by rupture or dislocation. The experience of the surgical and nursing staff is probably the most important factor in decreasing the total rate of complications.",
keywords = "Central venous catheter, complications, Port-A-Cath, Subcutaneous infusion port",
author = "Carlo Ballarini and M. Intra and {Pisani Ceretti}, A. and A. Cordovana and M. Pagani and G. Farina and S. Perrone and M. Tomirotti and A. Scanni and Spina, {G. P.}",
year = "1999",
month = "2",
doi = "10.1159/000011947",
language = "English",
volume = "56",
pages = "97--102",
journal = "Oncology",
issn = "0030-2414",
publisher = "UBM Medica Healthcare Publications",
number = "2",

}

TY - JOUR

T1 - Complications of subcutaneous infusion port in the general oncology population

AU - Ballarini, Carlo

AU - Intra, M.

AU - Pisani Ceretti, A.

AU - Cordovana, A.

AU - Pagani, M.

AU - Farina, G.

AU - Perrone, S.

AU - Tomirotti, M.

AU - Scanni, A.

AU - Spina, G. P.

PY - 1999/2

Y1 - 1999/2

N2 - Subcutaneous infusion ports (SIPs) represent a valid method for long-term chemotherapy. The SIPs have several advantages over other methods of venous access: they are easy to implant under local anaesthesia, have less discomfort for the patients, allow low costs, can be implanted in day hospital, and can be managed ambulatorily. However, SIPs have delayed complications, frequently related to clinical conditions of the neoplastic patients, and immediate complications, often due to the placement technique. From March 1992 to March 1997 we placed, under local anaesthesia and under fluoroscopic control, 102 SIPs in 99 general oncology patients for long-term chemotherapy (88% solid, 12% haematological tumours). The percutaneous venous access devices were in the subclavian vein in 96% of the cases and in the internal jugular vein in 4% of them. immediate complications were: 1 haemopneumothorax, which required thoracic aspirations and two blood transfusions, 1 loop of the tunneled part of the catheter without alterations in SIP function, and 1 left jugular thrombosis in a patient with subclavian veins already thrombosed. The venous access was in the subclavian vein in the first 2 cases, and it was not necessary to suspend the therapeutic program. In the third instance, implanted in jugular vein, it was necessary to remove the SIP. Delayed complications were: 1 necrosis of the skin over the port, 1 infection of subcutaneous pocket, 2 infections of the system, 1 catheter deconnection, and 3 catheter ruptures with embolization of the catheter tip. The SIPs were removed in all cases but 1 in whom infection was successfully treated by appropriate antibiotic therapy. Embolization of the catheter required removal from the pulmonary artery under fluoroscopic guidance in the cardiac catheterization laboratory. In conclusion, infection and thrombosis are the two major complications of SIP in general oncology patients. In these cases it is not necessary to remove systematically the system, but a correct therapy (antibiotic, fibrinolytic agents) can be utilized with good results. The catheter rupture is often due to the wear over the costoclavicular angle. The interventional radiology is the method of choice in the treatment of the catheter embolization by rupture or dislocation. The experience of the surgical and nursing staff is probably the most important factor in decreasing the total rate of complications.

AB - Subcutaneous infusion ports (SIPs) represent a valid method for long-term chemotherapy. The SIPs have several advantages over other methods of venous access: they are easy to implant under local anaesthesia, have less discomfort for the patients, allow low costs, can be implanted in day hospital, and can be managed ambulatorily. However, SIPs have delayed complications, frequently related to clinical conditions of the neoplastic patients, and immediate complications, often due to the placement technique. From March 1992 to March 1997 we placed, under local anaesthesia and under fluoroscopic control, 102 SIPs in 99 general oncology patients for long-term chemotherapy (88% solid, 12% haematological tumours). The percutaneous venous access devices were in the subclavian vein in 96% of the cases and in the internal jugular vein in 4% of them. immediate complications were: 1 haemopneumothorax, which required thoracic aspirations and two blood transfusions, 1 loop of the tunneled part of the catheter without alterations in SIP function, and 1 left jugular thrombosis in a patient with subclavian veins already thrombosed. The venous access was in the subclavian vein in the first 2 cases, and it was not necessary to suspend the therapeutic program. In the third instance, implanted in jugular vein, it was necessary to remove the SIP. Delayed complications were: 1 necrosis of the skin over the port, 1 infection of subcutaneous pocket, 2 infections of the system, 1 catheter deconnection, and 3 catheter ruptures with embolization of the catheter tip. The SIPs were removed in all cases but 1 in whom infection was successfully treated by appropriate antibiotic therapy. Embolization of the catheter required removal from the pulmonary artery under fluoroscopic guidance in the cardiac catheterization laboratory. In conclusion, infection and thrombosis are the two major complications of SIP in general oncology patients. In these cases it is not necessary to remove systematically the system, but a correct therapy (antibiotic, fibrinolytic agents) can be utilized with good results. The catheter rupture is often due to the wear over the costoclavicular angle. The interventional radiology is the method of choice in the treatment of the catheter embolization by rupture or dislocation. The experience of the surgical and nursing staff is probably the most important factor in decreasing the total rate of complications.

KW - Central venous catheter, complications

KW - Port-A-Cath

KW - Subcutaneous infusion port

UR - http://www.scopus.com/inward/record.url?scp=0033041613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033041613&partnerID=8YFLogxK

U2 - 10.1159/000011947

DO - 10.1159/000011947

M3 - Article

C2 - 9949293

AN - SCOPUS:0033041613

VL - 56

SP - 97

EP - 102

JO - Oncology

JF - Oncology

SN - 0030-2414

IS - 2

ER -