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经皮股静脉植入的端口导管系统经股静脉取出的并发症。

Complications of transfemoral removal of percutaneous transfemorally implanted port-catheter systems.

作者信息

Yahiro Yoshiyuki, Toyota Naoyuki, Kakizawa Hideaki, Hieda Masashi, Hirai Nobuhiko, Naito Akira, Ito Katsuhide

机构信息

Department of Radiology, Division of Medical Intelligence and Informatics, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi-cho, Minami-ku, Hiroshima 734-8551, Japan.

出版信息

Cardiovasc Intervent Radiol. 2006 Sep-Oct;29(5):752-5. doi: 10.1007/s00270-005-0291-x.

Abstract

Our purpose is to evaluate the feasibility and safety of the withdrawal procedure of percutaneous transfemorally implanted port-catheter systems. Thirty-seven patients (17.7%) underwent the withdrawal procedure of this port-catheter system among 209 patients. The reasons for withdrawal were as follows: termination of intra-arterial chemotherapy (n = 7), obstruction of hepatic artery (n = 5), port infection (n = 4), catheter infection (n = 4), catheter obstruction (n = 4), lower-limb palsy and pain (n = 2), exposure of the port due to skin defect (n = 2), patient's desire (n = 2), side effect of chemotherapy (n = 1), no effectiveness of chemotherapy (n = 1), hematoma at the puncture site (n = 1), duodenum perforation by the catheter (n = 1), intermittent claudication due to severe stenosis of right common iliac artery (n = 1), dissection of common hepatic artery (n = 1), and broken catheter (n = 1). In thirty-four of the 37 cases, the port-catheter system was successfully withdrawn without any complications. Clinical success rate was 91.9%. Complications occurred in three cases (8.1%), which were a pseudoaneurysm, thromboembolism of the right common iliac artery, and continuous bleeding from the subcutaneous pocket where the port system was placed for 1 month. In 15 cases, correction of the catheter tip or exchange for dislocation of the tip had to be done without withdrawal. It is not rare to withdraw port-catheter systems in cases of infection or hematoma around the system. Although withdrawal of a percutaneous transfemorally implanted port-catheter system is a relatively safe procedure, the port-catheter system should not be removed unless absolutely indicated.

摘要

我们的目的是评估经皮股动脉植入的端口导管系统拔除 procedure 的可行性和安全性。在 209 例患者中,37 例(17.7%)接受了该端口导管系统的拔除 procedure。拔除原因如下:动脉内化疗终止(n = 7)、肝动脉阻塞(n = 5)、端口感染(n = 4)、导管感染(n = 4)、导管阻塞(n = 4)、下肢麻痹和疼痛(n = 2)、由于皮肤缺损导致端口暴露(n = 2)、患者意愿(n = 2)、化疗副作用(n = 1)、化疗无效(n = 1)、穿刺部位血肿(n = 1)、导管导致十二指肠穿孔(n = 1)、右髂总动脉严重狭窄引起间歇性跛行(n = 1)、肝总动脉夹层(n = 1)以及导管断裂(n = 1)。在 37 例中的 34 例中,端口导管系统成功拔除,无任何并发症。临床成功率为 91.9%。3 例(8.1%)出现并发症,分别为假性动脉瘤、右髂总动脉血栓栓塞以及放置端口系统的皮下袋持续出血 1 个月。在 15 例中,不得不对导管尖端进行矫正或更换尖端脱位而不拔除。在系统周围发生感染或血肿的情况下拔除端口导管系统并不罕见。尽管经皮股动脉植入的端口导管系统的拔除是一个相对安全的 procedure,但除非有绝对指征,否则不应拔除端口导管系统。

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