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      Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous access.

      Radiology
      Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Infusion Pumps, Implantable, Male, Middle Aged, Parenteral Nutrition, Total, instrumentation, Radiology, Interventional, Time Factors, Veins

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          Abstract

          Implantable infusion port devices are generally placed surgically. A technique for radiology-guided placement in adults is described, and the experience with 103 attempted port placements between June 1989 and October 1991 is analyzed. Placements were successful in 102 attempts (99%). Minor procedural difficulties occurred in six patients (5.9%). One major procedural complication (large hematoma) precluded port placement. Two patients were lost to follow-up after uncomplicated placements. There were four (4.0% of 100 patients) minor late complications. Major late complications requiring port removal occurred in 13 (13.0%): five suspected catheter-related infections, four catheter-related venous thromboses refractory to thrombolysis, and one each of wound dehiscence, formation of hematoma near the port, extraluminal migration of the catheter, and poor blood return. With a cumulative follow-up of 15,880 days (43.5 patient-years) available, a rate of major complications of 13.6%, or 0.86% per 1,000 access days, is comparable to the rates of large surgical series. Radiology-guided placement of infusion ports is safe and may offer advantages over surgical implantation.

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