title: Prevention of intraprocedural puncture site bleeding during arterial port implantation by use of a suture-mediated arterial closure system: a prospective randomized trial.
abstract: OBJECTIVE
  To investigate a modified technique for arterial port placement that uses a suture-mediated closure system with the aim to reduce delays caused by intraprocedural oozing around the catheter.
  
  
  METHODS
  Forty consecutive patients (age, 63.9 y ± 11.8) stratified for regional arterial infusion chemotherapy were prospectively randomized to undergo conventional or modified port implantation. Time for device placement, total procedure time, number of catheters, size of largest and final catheters placed, duration of bleeding from puncture site, procedural delays, and time until hemostasis was achieved were recorded.
  
  
  RESULTS
  Time for device placement was 3.7 minutes ± 1.1, with no complications encountered. Total procedure times were 133.0 minutes ± 62.8 for conventional port implantation and 100.0 minutes ± 49.5 for modified implantation (P = .13). No differences were found in the number of catheters or size of largest or final catheter used. Duration of groin bleeding necessitating manual compression was 21.8 minutes ± 24.4 for conventional port implantation, resulting in a mean procedural delay of 6.2 minutes ± 7.0. Hemostasis was achieved after a mean of 17.1 minutes ± 20.9. Groin hematoma was observed in three patients. In contrast, with the modified technique, mean duration of oozing and intraprocedural delays were only 0.2 minutes ± 0.6 and 0.1 minutes ± 0.5, respectively (both P < .0001 vs conventional technique). Hemostasis was achieved within 3.2 minutes ± 4.1 (P < .0001), with no cases of hematoma found.
  
  
  CONCLUSIONS
  Use of a suture-mediated closure system facilitated arterial port implantation by effective prevention of groin bleeding while allowing the use of a sheath.
authors.affiliation: Department of Radiology and Nuclear Medicine, University of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany. oliver.dudeck@med.ovgu.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Dudeck
authors.forename: Skadi
authors.initials: S
authors.lastname: Wilhelmsen
authors.forename: Patrick
authors.initials: P
authors.lastname: Stübs
authors.forename: Roger
authors.initials: R
authors.lastname: Kuhn
authors.forename: Bernd-Uwe
authors.initials: BU
authors.lastname: Liehr
authors.forename: Joachim
authors.initials: J
authors.lastname: Bischoff
authors.forename: Bernd
authors.initials: B
authors.lastname: Bonnekoh
authors.forename: Jens
authors.initials: J
authors.lastname: Ricke
authors.forename: Maciej
authors.initials: M
authors.lastname: Pech
mesh_terms: D000368:Aged; D057785:Catheters; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects* / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005858:Germany; D006119:Groin / Q000098:blood supply*; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D011677:Punctures; D013536:Suture Techniques / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome