HOW SHOULD WE MANAGE THE CENTRAL VEIN ACCESS PORT SYSTEM IN OUTPATIENT CANCER CHEMOTHERAPY WHEN THE PORT SYSTEM CAN BE FLUSHED, BUT NO BLOOD ASPIRATED?

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Abstract

Background

There are no reported data on the management of the central vein access port (CV-port) system when the CV-port system can be flushed, but no blood aspirated, mainly because a small thrombus occludes the catheter tip (catheter tip thrombosis). Moreover, it remains unclear whether catheter tip thrombosis needs to be treated.

Methods

From April 2008 to January 2012, 199 patients who were treated with outpatient chemotherapy via a CV-port in the Center for Clinical Oncology, Okayama University Hospital, were analyzed retrospectively.

Results

Of the patients, no blood could be aspirated in 21 (17.6 %) when treated via a CV-port. The median time between CV-port placement and the failure of blood aspiration was 273 (range 7–1641) days. Among the patients with no blood aspiration from their CV-port, thirteen cases (61.9 %) had no complications other than failure of blood aspiration, and anticancer agents have been successfully administered. However, the other eight patients had their CV-port system replaced due to complications, including three catheter ruptures, two thrombotic events around the catheter, two infections, and one occlusion due to catheter bending.

Conclusions

Approximately 60% of patients might not require any treatment or intervention for the failure of blood aspiration from their CV-port. Medical staffs, however, should be aware that approximately one-third of the cases with no blood aspiration potentially have troubles with their CV-ports that need to be replaced.

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