Outpatient implantation of a central venous access system in gynecologic oncology patients.
OBJECTIVE
To determine the feasibility, accuracy, complications and cost of implantation of the PORT-A-CATH II Fluoro-Free venous access system (SIMS Deltec Inc., St. Paul, Minnesota) in the procedure room setting.


METHODS
A prospective study of 49 consecutive gynecologic oncology patients who underwent 53 PORT-A-CATH II System implantations was conducted. Local anesthesia and conscious sedation were used for the procedure. To localize and position the catheter tip, the CATH-FINDER (SIMS Deltec) electronic catheter sensing device was utilized. Demographic characteristics, operative data, complication rates, failure rates and itemized costs were collected and analyzed.


RESULTS
For the 53 ports implanted, the mean operative time was 54 minutes (range, 39-74) and mean estimated blood loss was 17 mL (range, 7-50). Immediate complications included failure to thread the catheter or guidewire past the left subclavian vein (4 patients), pneumothorax (1) and electronic wire fracture (1). All catheter tips were positioned accurately, as confirmed by chest radiography. The procedural charge ranged from $1,946 to $2,042. The CATH-FINDER obviated the need for, and expenses of, fluoroscopy, operating room and anesthesia services, resulting in savings of approximately $2,000 per procedure.


CONCLUSIONS
Implantation of the PORT-A-CATH II System was performed safely, accurately and cost effectively in the procedure room setting. The advantages of functional longevity, low complication rates and reduced cost of this port system offer an excellent option for long-term central venous access.
Shen-Gunther
Jane
J
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, USA. jshengunth@aol.com
Mannel
Robert S
RS
Walker
Joan L
JL
Gold
Michael A
MA
Johnson
Gary A
GA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002405:Catheterization, Central Venous / Q000191:economics* / Q000706:statistics & numerical data*; D002408:Catheters, Indwelling / Q000191:economics* / Q000706:statistics & numerical data*; D004868:Equipment Failure; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D009825:Oklahoma / Q000453:epidemiology; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000601:surgery