Atypical thrombotic and septic complications of totally implantable venous access devices in patients with cystic fibrosis.
The use of vascular access systems in patients with cystic fibrosis (CF) is well accepted, with lower overall complications and maintenance costs than percutaneous silastic catheters. We report our 6 year experience with 22 infusaports in 15 CF patients. Our patients had indwelling catheters for an average of 539 days per catheter (range, 14-2,224 days). These infusaports were used for home antibiotic therapy, blood sampling, and total parenteral nutrition. The overall complication rate was relatively low, 1 in every 1,483 catheter days. Infectious complications were extremely infrequent at a rate of 1 in 5,929 catheter days. The rate of mechanical complications was 1 in 1,976 catheter days. However, superior vena caval syndrome or deep venous thrombosis was associated with 3 of 22 catheters (13.6%). Due to this high incidence of major thrombotic events with the attendant risk of pulmonary embolism, all patients with CF using infusaports and without evidence of liver disease or bleeding problems receive aspirin prophylaxis.
Sola
J E
JE
Department of Surgery, Johns Hopkins University, Baltimore, Maryland.
Stone
M M
MM
Wise
B
B
Colombani
P M
PM
D000293:Adolescent; D000328:Adult; D001241:Aspirin / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D013479:Superior Vena Cava Syndrome / Q000209:etiology* / Q000517:prevention & control; D013924:Thrombophlebitis / Q000209:etiology* / Q000517:prevention & control
D001241:Aspirin