• Ann. Surg. Oncol. · Dec 2015

    Percutaneous Re-positioning of Dislocated Port-Catheters in Patients with Dysfunctional Central-Vein Port-Systems.

    • Alexander Massmann, Philippe Jagoda, Nicole Kranzhoefer, and Arno Buecker.
    • Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg/Saar, Germany. Alexander.Massmann@uks.eu.
    • Ann. Surg. Oncol. 2015 Dec 1; 22 (13): 4124-9.

    PurposeObservational analysis of percutaneous repositioning of displaced port-catheters in patients with dysfunctional central-venous port-systems.MethodsA total of 1061 patients with dysfunctional venous pectoral port-systems were referred for port-angiography. Dislocated port-catheters were identified in 37 (3.5 %) patients (11 males, mean age 58.1 ± 7.2 [range 48-69] years; 26 females, 57.0 ± 13.5 [range 24-75] years) 3.9 ± 6.6 months (range 1 day-26 months) after port-implantation. Percutaneous repositioning in all patients was performed by transfemoral catheter maneuvers, snaring, or wire-assisted long-loop snaring. Primary endpoint was successful repositioning. Safety endpoints included port-damage or procedure-related complications. Follow-up encompassed routine clinical and radiological controls, including chest X-ray or computed tomography for 12.9 ± 17.9 (range 1-81) months.ResultsClinical signs of port-dysfunction due to dislocation of port-catheters included difficult aspiration in 23 (62.2 %), resistance or inability to inject in 17 (46.0 %), and pain during injection in 2 (5.4 %) patients. Primary technical success for repositioning displaced port-catheters was 97.3 % (36/37 patients). In 1 (2.7 %) patient, repositioning failed due to complete embedding of the port-catheter in an extensive chronic jugular vein thrombosis (Paget-von-Schroetter syndrome) that prevented endovascular access to the port-catheter. Redisplacement occurred after initial successful repositioning: immediately in two patients due to a too short port-catheter (two-tailed Fisher's exact-test, p = 0.0101), and in two patients with appropriate catheter-length after 5, resp. 7 months. No procedure-associated complications, e.g., port-catheter disconnection or disruption, occurred.ConclusionsRepositioning of dysfunctional displaced central-venous port-catheters with appropriate catheter-length is safe and effective. Even challenging conditions, e.g., wall-adherent port-catheter tip or a thrombosed catheter-bearing vein are feasible. Repositioning of too short port-catheters is ineffective.

      Pubmed     Full text   Copy Citation  

      Add institutional full text...

    Notes

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.