Division of Interventional Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Department of Radiology, University of Vermont Medical Center, Burlington, VT, USA.
J Vasc Access. 2021 Mar;22(2):173-177. doi: 10.1177/1129729820932425. Epub 2020 Jun 15.
To evaluate the use of a dual-chambered venous access port for extracorporeal apheresis therapy.
This was a single-center retrospective analysis of all patients who received a dual-chambered venous access port for apheresis therapy over a 36-month period. Clinical success was defined as successful completion of at least one round of apheresis via the venous access port. Major complications were defined as any event requiring elevation of patient care and/or venous access port removal or repositioning. Minor complications were defined as venous access port issues resolved with clinical intervention.
Forty-four patients had a venous access port placed at the time of this study. Patients underwent red cell exchange (n = 33), therapeutic plasma exchange (n = 6) or extracorporeal photopheresis (n = 5). Forty (90%) patients had autoimmune diseases and four (10%) had neoplastic processes. Clinical success was achieved in 42 (95.5%) patients. Average venous access port dwell time was 632 days (range = 42-1191 days). All therapies through the venous access ports were well tolerated and no patients reported pain or discomfort. Major complications were seen in nine (20.5%) patients-the majority (n = 7) of which were due to venous access port malfunction-and resolved with catheter revision. One (2.27%) major complication involved an infected venous access port, and one involved a large hematoma at the venous access port site. Minor complications were seen in eight (18.2%) patients, where simple flushing of the catheter with saline or tissue plasminogen activator resolved the issue.
The dual-chambered venous access port was successfully used for sustained blood flow in apheresis therapy with a moderate, yet correctable complication rate.
评估双腔静脉接入端口在体外血液分离治疗中的应用。
这是一项在 36 个月内对所有接受双腔静脉接入端口进行血液分离治疗的患者进行的单中心回顾性分析。临床成功定义为通过静脉接入端口成功完成至少一轮血液分离治疗。主要并发症定义为任何需要提高患者护理水平和/或需要移除或重新定位静脉接入端口的事件。次要并发症定义为通过临床干预解决的静脉接入端口问题。
在本研究中，44 名患者植入了静脉接入端口。患者接受红细胞交换（n=33）、治疗性血浆置换（n=6）或体外光化学疗法（n=5）。40 名（90%）患者患有自身免疫性疾病，4 名（10%）患者患有肿瘤性疾病。42 名（95.5%）患者达到了临床成功。静脉接入端口平均留置时间为 632 天（范围 42-1191 天）。所有通过静脉接入端口进行的治疗均耐受良好，无患者报告疼痛或不适。9 名（20.5%）患者出现主要并发症-其中大多数（n=7）是由于静脉接入端口故障引起的-通过导管修改得到解决。1 例（2.27%）主要并发症涉及感染的静脉接入端口，1 例涉及静脉接入端口部位的大血肿。8 名（18.2%）患者出现轻微并发症，通过用生理盐水或组织纤溶酶原激活剂冲洗导管即可解决问题。
双腔静脉接入端口在血液分离治疗中成功地用于维持血流，并发症发生率适中，但可纠正。
