Long-term, tunneled, noncuffed central venous catheter in cancer patients (Vygon): safety, efficacy, and complications.
BACKGROUND
Totally implantable or partially cuffed central venous catheters (CVC) are commonly used in cancer patients, but they are often expensive and may produce complications. To minimize costs, we have been using a low-cost, partially tunneled, silicone elastomer catheter with no Dacron cuff or antireflux valve (Vygon) since 2001. This study is a retrospective investigation of our experience using the Vygon catheter as a long-term CVC in patients with malignancy.


METHODS
A total of 458 Vygon catheters (Nutricath, Vygon) were percutaneously inserted by an interventional radiologist in 302 cancer patients. The median duration of catheter use was 93 days, mean 164.3 days (range 1-789). Main patient characteristics were as follows: number of male/female patients, 166/136; median age, 51 years; hematological/nonhematological patients, 189/113.


RESULTS
Early complications were pneumothorax in six and hematoma in twelve of 458 implants, respectively. Thirteen out of 302 patients developed a catheter-related thrombosis. One hundred and thirty-five of 458 Vygon catheters required removal because of catheter-related complications: 68 accidental losses, 37 cases of febrile neutropenia suspected to be catheter-related, ten catheter dislodgements, ten catheter malfunctions, four local infections, three thromboses, two catheter ruptures, and one allergic reaction.


CONCLUSIONS
Vygon catheters do not seem to induce more early and late complications as compared with other more expensive devices, except for disadvantage of the high incidence rate of accidental losses.
Masci
Giovanna
G
Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Milano, Italy. giovanna.masci@humanitas.it
Magagnoli
Massimo
M
Pedicini
Vittorio
V
Poretti
Dario
D
Castagna
Luca
L
Carnaghi
Carlo
C
Morenghi
Emanuela
E
Del Vecchio
Antonietta
A
Finotto
Rita
R
Brambilla
Giorgio
G
Santoro
Armando
A
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D020878:Device Removal; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D016459:Prosthesis-Related Infections / Q000209:etiology; D012189:Retrospective Studies; D013350:Subclavian Vein / Q000601:surgery; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000601:surgery
D000970:Antineoplastic Agents