Power-injectable totally implantable venous access devices - analysis of success and complication rates of ultrasound-guided implantation and a patient satisfaction survey.

Abstract

Background: To retrospectively evaluate the success rates, peri-interventional, early and late complications and patient satisfaction associated with power-injectable totally implantable venous access devices (TIVAPs). Patients and methods: Between April 2011 and March 2016, a total of 1,203 TIVAPs were implanted in 1,169 patients. Ultrasound-guided, fluoroscopically controlled implantation was performed through the subclavian or internal jugular vein. The systematic analysis focused on the rate of successful port implantations, the frequency of peri-interventional, early and late complications and on how the experience of the implanting radiologist impacts these parameters. Additionally, a standardized questionnaire was administered to the 102 study patients in a telephone interview to survey their subjective rating of the port implantation. Results: 99.5% of TIVAPs were implanted successfully. In 4 out of 6 patients, the implantation was repeated successfully at a later time. Complication rates were 1.4% (0.0512/1.000 catheter days) for peri-interventional, 2.9% (0.081 per 1,000 catheter days) for early and 8.3% (0.2288 per 1,000 catheter days) for late complications. The radiologist's experience level and vein selection did not have a significant impact. Most peri-interventional complications (82.4%) were of minor severity. The early (61.5%) and late (65.6%) complications were more frequently of major severity. Interventions to manage complications comprised port explanation in 46.9%, conservative therapy in 17.4% and interventional therapy in 12.2%. At 1 and 3 months after port placement, the majority were satisfied or very satisfied with the interventional port implantation. Conclusions: Ultrasound-guided, fluoroscopically controlled implantation of TIVAPs is a safe procedure with low complication rates, high success rates and high patient satisfaction.