Zottele Bomfim Guilherme A, Wolosker Nelson, Yazbek Guilherme, Bernardi Christiano V, Valentim Luisa A, De Castro Thiago M, Pignataro Bruno S, Benitti Daniel A, Nishinari Kenji
Hospital A.C. Camargo Cancer Center, São Paulo, Brazil.
Hospital A.C. Camargo Cancer Center, São Paulo, Brazil.
Ann Vasc Surg. 2014 Feb;28(2):351-7. doi: 10.1016/j.avsg.2013.01.025. Epub 2013 Oct 3.
Fully implantable catheters are important for oncology treatments. They can be functionally categorized as valved or nonvalved. Theoretically, a valve prevents spontaneous blood reflux into the catheter, reducing the incidence of complications. We sought to compare the results from the implantation of valved and nonvalved fully implantable 8-French catheters inserted via ultrasound-guided puncture in cancer patients undergoing chemotherapy treatment.
A retrospective analysis of 100 patients who underwent long-term catheter implantation guided by ultrasound was performed looking for early (≤30 days) or late (≥90 days) complications. They were evaluated regarding the use of valved or nonvalved catheter and assessed on univariate model.
The only early complication (hematoma) was identified in the valved group. Twenty-two late complications were identified (72.72% in the valved group and 27.27% in the nonvalved group; P = 0.009). Blood reflux dysfunction, which occurred in 12 patients in the valved and none in the nonvalved devices group, was the only complication with an incidence that was significantly different between the groups.
Fully implantable valved catheters with Groshong (Bard Medical Division, Covington, GA) valves have a higher rate of blood reflux dysfunction compared with nonvalved catheters, but this did not interfere with the efficacy of the treatment.
完全植入式导管对肿瘤治疗很重要。它们在功能上可分为带瓣膜的或无瓣膜的。理论上，瓣膜可防止血液自发反流至导管内，从而降低并发症的发生率。我们试图比较在接受化疗的癌症患者中，经超声引导穿刺植入带瓣膜和无瓣膜的完全植入式8法式导管的结果。
对100例接受超声引导下长期导管植入的患者进行回顾性分析，寻找早期（≤30天）或晚期（≥90天）并发症。根据使用带瓣膜或无瓣膜导管的情况对患者进行评估，并在单变量模型中进行分析。
带瓣膜组发现了唯一的早期并发症（血肿）。共发现22例晚期并发症（带瓣膜组占72.72%，无瓣膜组占27.27%；P = 0.009）。血液反流功能障碍是两组间发生率有显著差异的唯一并发症，带瓣膜装置组有12例发生，无瓣膜装置组无发生。
与无瓣膜导管相比，带有Groshong瓣膜（巴德医疗部门，佐治亚州卡温顿）的完全植入式带瓣膜导管发生血液反流功能障碍的比率更高，但这并未影响治疗效果。
