Abstract
Purpose: The use of port catheters is well accepted in the management of patients with malignancy. In this study, we compare the technical success and the complication rates of ultrasound guided Port-A-Cath implantation with doing this procedure by using the anatomical landmark method. Methods: In a retrospective study, from 2006 to 2009, medical files of 104 patients who had undergone Port-A-Cath implantation were reviewed. The indication for port catheter implantation was malignancy in all cases. Among our patients, Port-A-Cath implantation was done in 63 patients by using landmark method and in 41 patients by guidance of ultrasound. All patients had been observed for complications including pain, port infection, and port thrombus, thrombus of central veins, skin necrosis, and success in using of Port-A-Cath for at least one month following the procedure, in the vascular clinic. Results: in landmark method group, 2 catheters were non-functional just after placement (3.2%) while all Port-A-Caths in ultrasound-guided group were functional. Ten patients (15.9%) in land mark group and 1 patient (2.4%) in ultrasound-guided group were complicated. The difference between complication rate in anatomic landmarks method and ultrasound-guided method was statistically significant (p There was no significant difference in two groups in duration of port placement (p
Highlights
By introducing different chemotherapeutic agents and considering complexities of anti-cancer treatment protocols, the need for reliable vascular access has significantly increased in two recent decades [1]
Port-A-Cath implantation was done in 63 patients by using landmark method and in 41 patients by guidance of ultrasound
Considering rate of various complications following administration of chemotherapeutic agents via peripheral veins in oncologic patients which are mainly related to the adverse effects of these agents at the site of injection, reliable access to the central vein is necessary [20]
Summary
By introducing different chemotherapeutic agents and considering complexities of anti-cancer treatment protocols, the need for reliable vascular access has significantly increased in two recent decades [1]. Port-A-caths provide safe and long term access to central veins for chemotherapy [11]. Port-ACath is implanted by using anatomical signs on skin surface [12]. It is essentially a blind process [13] which is with lower success and more complications [14]. Ultra sonography can be applied to evaluate the anatomic structures before attempting the puncture. It increases rate of success [15] and decreases the complications [15] [16]. The use of ultra sound and the entrance of the catheter even in western countries are not much acceptable and are merely used partly [12]
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