Wildgruber Moritz, Lueg Claudia, Borgmeyer Sebastian, Karimov Ilham, Braun Ulrike, Kiechle Marion, Meier Reinhard, Koehler Michael, Ettl Johannes, Berger Hermann
Division of Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, D-81675 Munich, Germany; Department of Clinical Radiology, Universitätsklinikum Münster, D 48149 Münster, Germany.
Division of Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, D-81675 Munich, Germany.
Eur J Cancer. 2016 May;59:113-124. doi: 10.1016/j.ejca.2016.02.011. Epub 2016 Mar 26.
We aimed to analyse short and long-term complications of polyurethane (PU) versus silicone catheters used in totally implantable venous-access ports (TIVAPs) implanted at the forearm.
Retrospective analysis of 698 consecutively implanted TIVAPs was performed. Primary end-points were defined as rates of major complications associated with either type of central venous port catheter. Technical success rate, device service interval as well as minor complications not requiring port explantation were defined as secondary end-points.
A total of 698 port devices were implanted in 681 patients, 396 equipped with a PU catheter, 302 with a silicone catheter. The technical success rate was 99.9% with no major periprocedural complications. During follow-up a total of 211 complications in 146 patients were observed (1.0/1000 catheter days), 183 occurred associated with PU catheters (1.8/100 catheter days), 28 (0.3/1000 catheter days) with silicone catheters (log rank test p < 0.0001). Catheter-related bloodstream infections as well as thrombotic complications occurred significantly more frequently with PU catheters, while silicone catheters exhibited a trend towards a higher rate of mechanical failure such as disconnection or catheter rupture. Major complications requiring explantation of the device occurred more frequently with PU-based catheters (10.6%) compared to silicone catheter carrying ports (4.6%, log rank test p < 0.001).
PU catheters are more susceptible to catheter-related infections and exhibit a higher thrombogenicity, compared to silicone catheters. Silicone catheters instead exhibit a trend towards decreased mechanical stability.
我们旨在分析在前臂植入的全植入式静脉通路端口（TIVAP）中使用的聚氨酯（PU）导管与硅胶导管的短期和长期并发症。
对698例连续植入的TIVAP进行回顾性分析。主要终点定义为与任何一种中心静脉端口导管相关的主要并发症发生率。技术成功率、设备使用间隔以及不需要取出端口的轻微并发症定义为次要终点。
681例患者共植入698个端口装置，其中396个配备PU导管，302个配备硅胶导管。技术成功率为99.9%，围手术期无重大并发症。随访期间，共观察到146例患者出现211例并发症（1.0/1000导管日），其中183例与PU导管相关（1.8/100导管日），28例（0.3/1000导管日）与硅胶导管相关（对数秩检验p<0.0001）。PU导管相关的血流感染和血栓形成并发症明显更频繁发生，而硅胶导管出现机械故障（如断开或导管破裂）的发生率有更高的趋势。与携带硅胶导管的端口（4.6%，对数秩检验p<0.001）相比，需要取出装置的主要并发症在基于PU的导管中更频繁发生（10.6%）。
与硅胶导管相比，PU导管更容易发生导管相关感染，且血栓形成性更高。相反，硅胶导管有机械稳定性降低的趋势。
