Abstract

IntroductionPort implantations at the forearm are associated with an increased risk of relevant vein thrombosis. Therefore, with this study we sought to identify the responsible risk factors to improve technical quality of the method.MethodsThis is a retrospective analysis of 313 patients with port implantation at the forearm in 2019. Then, exploratory statistics were conducted comprising Cox-Regression and Kaplan-Meier-Analyses.ResultsMean age was 60 ± 14 years. 232 (74%) of the patients were female. No early infection was observed. 29 late infections and 57 cases of thrombosis occurred. In only 9% of the patients with thrombosis hospital admission was necessary for treatment. Median interval to the diagnosis of thrombosis was 23 days; inter-quartile-range: 16–75. Mean interval to elective port explantation was 227 ± 128 days. There was no effect of occurrence of thrombosis of the interventionalist, the assistance nor of several technical aspects. However, there was a significantly lower risk of thrombosis for primary implanted port system compared to replacement ports, Hazard-ratio: 0.34 [Confidence interval: 0.172, 0.674], p = 0.002. Age was a significant risk factor for late infections, Hazard-ratio: 3.35 [Confidence interval:1.84, 6.07], p < 0.0001.ConclusionThe main risk factor for adverse outcome after radiographically guided port implantation at the forearm is the type of the implanted port system. The reason for that might not be the material itself but the experience of a team with a certain port system. Age is a risk factor for late complications.

Highlights

  • MethodsThis is a retrospective analysis of 313 patients with port implantation at the forearm in 2019

  • Port implantations at the forearm are associated with an increased risk of relevant vein thrombosis

  • In only 9% of the patients with thrombosis hospital admission was necessary for treatment

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Summary

Methods

This is a retrospective analysis of 313 patients with port implantation at the forearm in 2019. This is a retrospective analysis of all patients with port implantation at the forearm from January to July 2019 in our department. Description of port catheter implantation with forearm access. A hydrophilic terumo 0.035" standard wire was advanced to the right atrium under fluoroscopic guidance. 0.5 ml of Scandicain was administered intracutaneously at the puncture site. The puncture site was augmented to a diameter of 3 mm using a standard scalpel. The port catheter itself was inserted over the wire. 9.5 ml of Scandicain was administrated subcutaneously 4 cm distal of the puncture site for the skin inscision. Skin inscision was made using a standard scalpel

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