During the last decade, the use of totally implantable devices for prolonged venous access (Subcutaneous Infusion Ports SIPs) has been widely spreading for the administration of chemotherapy, parenteral nutrition, antibiotics, analgesics, blood products. SIP-related complications are reported with an incidence ranging between 4% and 39%. We describe the results of a prospective study performed to assess the safety and effectiveness of these devices. Materials and methods. Between April 1, 1991 and January 6, 1995, 200 SIPs were implanted in 192 patients. Inclusion criteria were the need for central venous access and life expectancy of more than 1 month in the presence of: 1) prolonged and/or repeated therapy including phlebotoxic drugs; 2) continuous infusion therapy; 3) unsuitability of peripheral venous accesses. Exclusion criteria were: 1) life expectancy of less than 1 month; 2) patient refusal. At the time of enrollment, demographic data, primary diagnosis and indication for the placement were recorded. The surgical procedure was performed using the catheter through peel-away technique and all perioperative complications were recorded. For the purpose of the study, the follow-up period was extended through June 30, 1995. During the follow-up period, patient survival and all SIP-related complications were recorded. Perioperative and long term complications were classified as major and minor complications. Results. The study population consisted of 104 males/88 females, with a mean age of 48.7±17.3 years (range 25-82 years). 166 patients (86.4%) receiving 174 SIPs proved suitable for long-term analysis, while 26 patients (13.6%) were excluded due to missing data. By the end of the follow-up period, 41 patients (24.6%) died for causes unrelated to the SIP. Cumulative SIP permanence was 26375 patient days. Mean SIP survival was 151.5 days (range 3-1170 days). 20 SIP (11.4%) were removed during the follow-up period. Perioperative complications were recorded in 16% of the 200 procedures; the incidence of pneumothorax and arterial puncture was 5% and 8%, respectively. Long term complications were recorded in 14.9% of the 174 SIPs, including mechanical complications (6.3%), infections (5.1%) and venous thrombosis (2.2%). Minor and major complication rates were 20.1% and 10.3%, respectively. Conclusions. Subcutaneous infusion ports are safe and effective devices, representing the first choice approach for prolonged venous access in patients receiving parenteral nutrition or chemotherapy.
|Translated title of the contribution||Totally implantable devices for prolonged venous access. A prospective study of 200 cases|
|Number of pages||9|
|Publication status||Published - 1997|
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