TY - JOUR
T1 - GAVeCeLT consensus statement on the correct use of totally implantable venous access devices for diagnostic radiology procedures
AU - Bonciarelli, Giorgio
AU - Batacchi, Stefano
AU - Biffi, Roberto
AU - Buononato, Massimo
AU - Damascelli, Bruno
AU - Ghibaudo, Flavio
AU - Orsi, Franco
AU - Pittiruti, Mauro
AU - Scoppettuolo, Giancarlo
AU - Verzè, Alessia
AU - Borasi, Guido
AU - de Cicco, Marcello
AU - Dosio, Roberto
AU - Gazzo, Paolo
AU - Maso, Renzo
AU - Roman, Alessandro
AU - Ticha, Vladimira
AU - Venier, Giacomo
AU - Blackburn, Paul
AU - Goossens, Godelieve A.
AU - Santolucito, Jamie Bowen
AU - Stas, Marguerite
AU - van Boxtel, Ton
AU - Vesely, Thomas M.
AU - de Lutio, Enrico
PY - 2011/10
Y1 - 2011/10
N2 - The use of totally implantable venous access devices in radiology may be associated with complications such as occlusion of the system (because of the high density of some contrast), infection (if the port is not handled in aseptic conditions, using proper barrier protections), and mechanical complications due to the high-pressure administration of contrast by automatic injectors (so-called power injector), including extravasation of contrast media into the soft tissues, subintimal venous or myocardial injection, or serious damage to the device itself (breakage of the external connections, dislocation of the noncoring needle, or breakage of the catheter). The last problem - i.e., the damage of the device from a power injection - is not an unjustified fear, but a reality. A warning by the US Food and Drug Administration of July 2004 reports around 250 complications of this kind, referring to both port and central venous catheters and peripherally inserted central catheter systems, which occurred over a period of several years; in all cases, the damage occurred during the injection of contrast material by means of power injectors for computed tomography or magnetic resonance imaging procedures. Though the risk associated with the use of ports in radiodiagnostics is thus clear, it has been suggested that administration of the contrast material via the port may have some advantage in terms of image quality, increased comfort for the patient, and maybe more accurate reproducibility of the patient's own follow-up exams. This contention needs to be supported by evidence. Also, since many cancer patients who need frequent computed tomography studies already have totally implantable systems, it would seem reasonable to try to define how and when such systems may safely be used. The purpose of this consensus statement is to define recommendations based on the best available evidence, for the safe use of implantable ports in radiodiagnostics.
AB - The use of totally implantable venous access devices in radiology may be associated with complications such as occlusion of the system (because of the high density of some contrast), infection (if the port is not handled in aseptic conditions, using proper barrier protections), and mechanical complications due to the high-pressure administration of contrast by automatic injectors (so-called power injector), including extravasation of contrast media into the soft tissues, subintimal venous or myocardial injection, or serious damage to the device itself (breakage of the external connections, dislocation of the noncoring needle, or breakage of the catheter). The last problem - i.e., the damage of the device from a power injection - is not an unjustified fear, but a reality. A warning by the US Food and Drug Administration of July 2004 reports around 250 complications of this kind, referring to both port and central venous catheters and peripherally inserted central catheter systems, which occurred over a period of several years; in all cases, the damage occurred during the injection of contrast material by means of power injectors for computed tomography or magnetic resonance imaging procedures. Though the risk associated with the use of ports in radiodiagnostics is thus clear, it has been suggested that administration of the contrast material via the port may have some advantage in terms of image quality, increased comfort for the patient, and maybe more accurate reproducibility of the patient's own follow-up exams. This contention needs to be supported by evidence. Also, since many cancer patients who need frequent computed tomography studies already have totally implantable systems, it would seem reasonable to try to define how and when such systems may safely be used. The purpose of this consensus statement is to define recommendations based on the best available evidence, for the safe use of implantable ports in radiodiagnostics.
KW - Contrast media
KW - Extravasation
KW - High pressure
KW - Implantable ports
KW - Power injection
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U2 - 10.5301/JVA.2011.7736
DO - 10.5301/JVA.2011.7736
M3 - Article
C2 - 21534233
AN - SCOPUS:83455257802
VL - 12
SP - 292
EP - 305
JO - Journal of Vascular Access
JF - Journal of Vascular Access
SN - 1129-7298
IS - 4
ER -