Experience with a new percutaneous port system, Percuseal, for intravenous injection in patients with haemophilia, von Willebrand disease and severe alpha1-antitrypsin deficiency.
We have implanted a new port system (Percuseal) in altogether 13 patients with haemophilia A, B, von Willebrand disease and alpha1-antitrypsin deficiency in order to facilitate venous access. The Percuseal system differs from subcutaneous ports, such as Port-a-Cath, in that the upper part of the device protrudes above the skin. In this way, the patient can easily puncture the port membrane under the guidance of his eyes without penetrating the skin. In the present study cohort, a number of complications occurred. These were mainly caused by repeated local infections (in five patients), which made it necessary to replace the ports in three of the patients and to permanently remove the ports as the first option in two of the patients. In one patient, the port was removed because of inconvenience when doing physical exercise. In one additional patient, a severe systemic infection occurred, causing spondylitis. Despite the high infection rate, most patients considered the device very convenient to use. Because of the side-effects seen in our study, the Percuseal port in its present form is not to be recommended for regular use. A reconstruction of the port, making it smaller and giving it an antibacteriostatic cap, may possibly make this kind of port system a feasible alternative to use in order to improve pharmacoeconomics in the prophylactic treatment of haemophilia and patients with alpha1-antitrypsin deficiency.
Berntorp
E
E
Department for Coagulation Disorders, Lund University, Malmö University Hospital, Malmö, Sweden. erik.berntorp@medforsk.mas.lu.se
Piitulainen
E
E
Lethagen
S
S
Mattson
E
E
Tengborn
L
L
Mätzsch
T
T
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000635:transmission; D025861:Blood Coagulation Disorders, Inherited / Q000188:drug therapy*; D001779:Blood Coagulation Factors / Q000008:administration & dosage* / Q000627:therapeutic use; D002408:Catheters, Indwelling; D002648:Child; D016503:Drug Delivery Systems / Q000009:adverse effects / Q000295:instrumentation*; D004866:Equipment Contamination; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006467:Hemophilia A / Q000188:drug therapy; D002836:Hemophilia B / Q000188:drug therapy; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019896:alpha 1-Antitrypsin Deficiency / Q000188:drug therapy; D014842:von Willebrand Diseases / Q000188:drug therapy
D001779:Blood Coagulation Factors