Teichgräber Ulf Karl-Martin, Streitparth Florian, Cho Chie Hee, Benter Thomas, Gebauer Bernhard
Department of Radiology, Charité Campus Mitte, Charitéplatz 1, Berlin, Germany.
Cardiovasc Intervent Radiol. 2009 Sep;32(5):975-9. doi: 10.1007/s00270-008-9477-3. Epub 2008 Dec 16.
The purpose of this study was to evaluate whether low-profile totally implanted central venous port systems can reduce the late complication of skin perforation. Forty patients (age, 57 +/- 13 years; 22 females, 18 males) were randomized for the implantation of a low-profile port system, and another 40 patients (age, 61 +/- 14 years; 24 females, 16 males) received a regular port system as control group. Indications for port catheter implantation were malignant disease requiring chemotherapy. All port implantations were performed in the angiography suite using sonographically guided central venous puncture and fluoroscopic guidance of the catheter placement. Procedure time, number of complications (procedure-related immediate, early, and late complications), and number of explantations were assessed. Follow-up was performed for 6 months. All port implantations were successfully completed in both study groups. There were two incidents of skin perforation observed in the control group. One skin perforation occurred 13 weeks and the other 16 weeks after port implantation (incidence, 5%) in patients with regular-profile port systems. Two infections were observed, one port infection in each study group. Both infections were characterized as catheter-related infections (infection rate: 0.15 catheter-related infections per 1000 catheter days). In conclusion, low-profile port systems can be placed as safely as traditional chest ports and reduce the risk of developing skin perforations, which occurs when the port system is too tight within the port pocket.
本研究的目的是评估低轮廓全植入式中心静脉端口系统是否能减少皮肤穿孔的晚期并发症。40例患者(年龄57±13岁;女性22例,男性18例)被随机分配植入低轮廓端口系统,另外40例患者(年龄61±14岁;女性24例,男性16例)接受常规端口系统作为对照组。端口导管植入的指征是需要化疗的恶性疾病。所有端口植入均在血管造影室进行,采用超声引导下的中心静脉穿刺和导管放置的荧光透视引导。评估手术时间、并发症数量(与手术相关的即刻、早期和晚期并发症)以及取出装置的数量。随访6个月。两个研究组的所有端口植入均成功完成。对照组观察到2例皮肤穿孔事件。在使用常规轮廓端口系统的患者中,1例皮肤穿孔发生在端口植入后13周,另1例发生在16周后(发生率为5%)。观察到2例感染,每个研究组各有1例端口感染。这两种感染均被归类为导管相关感染(感染率:每1000导管日0.15例导管相关感染)。总之,低轮廓端口系统的放置与传统胸部端口一样安全,并降低了皮肤穿孔的风险,皮肤穿孔发生在端口系统在端口袋内过紧时。