Risk of deep venous thrombosis associated with chest versus arm central venous subcutaneous port catheters: a 5-year single-institution retrospective study.
OBJECTIVE
To determine the risk of deep venous thrombosis (DVT) in patients undergoing placement of central (chest) versus peripheral (arm) ports.


METHODS
Between January 1996 and December 2000, a total of 440 implantable chest or arm ports were placed in 422 patients. Data pertaining to the first port placed for each patient was analyzed. Ports were placed for chemotherapy (n = 415) or blood transfusion (n = 7). Subset analysis was performed, taking into consideration whether patients received prophylactic or therapeutic doses of warfarin sodium (Coumadin), to determine if there was any difference in the incidence of DVT between patients undergoing some form of anticoagulation versus those undergoing none. The medical records of these patients were reviewed to determine outcome with reference to development of DVT.


RESULTS
In 273 chest ports placed, there were 13 (4.8%) instances of DVT; in 149 peripheral ports, there were 17 (11.4%). Censoring data on patients receiving some form of anticoagulation, the respective incidences were eight of 245 (3.3%) and 14 of 129 (10.9%). With use of Kaplan-Meier analysis and log-rank tests to examine comparisons of interest, the probability of thrombosis occurring over a period of 180 days was higher with peripheral ports irrespective of Coumadin use (P =.007 for all patients considered, P =.002 when analyzed only for those not receiving Coumadin). The difference in incidence of thrombosis for all ports between patients receiving Coumadin versus those not receiving Coumadin was not significant.


CONCLUSIONS
Compared to chest ports, peripheral ports are associated with a significantly higher incidence of DVT.
Kuriakose
Philip
P
Department of Internal Medicine, Division of Hematology/Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32256, USA. kuriakose.philip@mayo.edu
Colon-Otero
Gerardo
G
Paz-Fumagalli
Ricardo
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D001132:Arm / Q000098:blood supply*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013909:Thorax / Q000098:blood supply*; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*
D000925:Anticoagulants