Use of totally implantable central venous access port via the basilic vein in patients with thoracic malignancies.
BACKGROUND
For patients with a thoracic malignancy whose peripheral veins are not suitable for blood access for chemotherapy, we evaluated a totally implantable central venous access port, in which the port is implanted in the ulnar side of the arm and the catheter is introduced via the basilic vein into the superior vena cava (TIAP-BV).


METHODS
Twenty-five patients (21 with lung cancer, 2 with malignant pleural mesothelioma, and 2 with thymoma) receiving TIAP-BV were included. Indications, surgical complications, and long-term complications were analyzed.


RESULTS
Indications for TIAP-BV were: chemotherapy (17 patients) and chemotherapy with parenteral nutrition (8 patients). The following surgical complications occurred: arrhythmia due to misplacement of the tip of catheter (1 patient); intraoperative conversion from the left to right arm (2 patients); and hematoma at the implantation site (1 patient). Short-term problems were: death 1 week after implantation without the use of TIAP-BV (2 patients). Long-term complications were: skin ulcer at the port site (1 patient); early removal of TIAP-BV because of port site infection (1 patient); catheter occlusion (1 patient); and venous thrombosis of basilic vein (2 patients). In the 22 patients who did not die early or have the device withdrawn early, the median duration of TIAP-BV use was 7 months (range, 1 to 20 months) without any break to the port system, leakage of drugs, or catheter-related infections.


CONCLUSIONS
TIAP-BV can be employed for long-term use for chemotherapy and parenteral nutrition. However, a patient's expected prognosis and infectious disease status at the time of implantation surgery should be considered before the surgery proceeds.
Sonobe
Makoto
M
Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin-kawaracho, Sakyo-ku, Kyoto, 606-8507, Japan. mysonobe@kuhp.kyoto-u.ac.jp
Chen
Fengshi
F
Fujinaga
Takuji
T
Sato
Kiyoshi
K
Shoji
Tsuyoshi
T
Sakai
Hiroaki
H
Miyahara
Ryo
R
Bando
Toru
T
Okubo
Kenichi
K
Hirata
Toshiki
T
Date
Hiroshi
H
D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014683:Vena Cava, Superior