title: GAVeCeLT* consensus statement on the correct use of totally implantable venous access devices for diagnostic radiology procedures.
abstract: The use of totally implantable venous access devices in radiology may be associated with complications such as occlusion of the system (because of the high density of some contrast), infection (if the port is not handled in aseptic conditions, using proper barrier protections), and mechanical complications due to the high-pressure administration of contrast by automatic injectors (so-called power injector), including extravasation of contrast media into the soft tissues, subintimal venous or myocardial injection, or serious damage to the device itself (breakage of the external connections, dislocation of the non-coring needle, or breakage of the catheter). The last problem - i.e., the damage of the device from a power injection - is not an unjustified fear, but a reality. A warning by the US Food and Drug Administration of July 2004 reports around 250 complications of this kind, referring to both port and central venous catheters and peripherally inserted central catheter systems, which occurred over a period of several years; in all cases, the damage occurred during the injection of contrast material by means of power injectors for computed tomography or magnetic resonance imaging procedures. Though the risk associated with the use of ports in radiodiagnostics is thus clear, it has been suggested that administration of the contrast material via the port may have some advantage in terms of image quality, increased comfort for the patient, and maybe more accurate reproducibility of the patient's own follow-up exams. This contention needs to be supported by evidence. Also, since many cancer patients who need frequent computed tomography studies already have totally implantable systems, it would seem reasonable to try to define how and when such systems may safely be used. The purpose of this consensus statement is to define recommendations based on the best available evidence, for the safe use of implantable ports in radiodiagnostics.
authors.affiliation: Medical Oncology Unit, Azienda ULSS 17, Este, Monselice, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bonciarelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Batacchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
authors.forename: Massimo
authors.initials: M
authors.lastname: Buononato
authors.forename: Bruno
authors.initials: B
authors.lastname: Damascelli
authors.forename: Flavio
authors.initials: F
authors.lastname: Ghibaudo
authors.forename: Franco
authors.initials: F
authors.lastname: Orsi
authors.forename: Mauro
authors.initials: M
authors.lastname: Pittiruti
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Scoppettuolo
authors.forename: Alessia
authors.initials: A
authors.lastname: Verzè
authors.forename: Guido
authors.initials: G
authors.lastname: Borasi
authors.forename: Marcello
authors.initials: M
authors.lastname: De Cicco
authors.forename: Roberto
authors.initials: R
authors.lastname: Dosio
authors.forename: Paolo
authors.initials: P
authors.lastname: Gazzo
authors.forename: Renzo
authors.initials: R
authors.lastname: Maso
authors.forename: Alessandro
authors.initials: A
authors.lastname: Roman
authors.forename: Vladimira
authors.initials: V
authors.lastname: Ticha
authors.forename: Giacomo
authors.initials: G
authors.lastname: Venier
authors.forename: Paul
authors.initials: P
authors.lastname: Blackburn
authors.forename: Godelieve A
authors.initials: GA
authors.lastname: Goossens
authors.forename: Jamie
authors.initials: J
authors.lastname: Bowen Santolucito
authors.forename: Marguerite
authors.initials: M
authors.lastname: Stas
authors.forename: Ton
authors.initials: T
authors.lastname: Van Boxtel
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Vesely
authors.forename: Enrico
authors.initials: E
authors.lastname: de Lutio
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000592:standards; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000592:standards; D003287:Contrast Media / Q000008:administration & dosage; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D007267:Injections; D053783:Magnetic Resonance Imaging, Interventional / Q000009:adverse effects / Q000295:instrumentation* / Q000592:standards; D061214:Patient Safety; D011237:Predictive Value of Tests; D011312:Pressure; D015641:Radiography, Interventional / Q000009:adverse effects / Q000295:instrumentation* / Q000592:standards; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D003287:Contrast Media