Yang Woo Jin, Song Myung Gyu, Seo Tae-Seok, Kang Danbee, Park Sung-Joon, Kwak Jung Won
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Guro-gu, Seoul, Republic of Korea.
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Gangnam-gu, Seoul, Republic of Korea.
J Vasc Access. 2024 Oct 14:11297298241282822. doi: 10.1177/11297298241282822.
This study aimed to assess the safety and feasibility of a 3-month flushing interval for totally implantable venous access ports (TIVAPs), particularly regarding intraluminal clot formation.
Between May 2017 and September 2018, we established a single-center cohort of 151 patients who were referred for TIVAP removal and categorized them into three flushing-interval groups: A (⩽1 month), B (1-2 months), and C (2-3 months). Odds ratios (OR) with 95% confidence intervals (CI) were computed using logistic regression to determine the risk of intraluminal clot occurrence. To compare clot lengths among the groups, we employed linear regression. Restricted cubic splines were used to model the flushing interval as a continuous variable.
Compared to Group A, Groups B and C had adjusted ORs of 0.82 (0.35-1.92) and 0.78 (0.29-2.11) for intraluminal clot risk. Occlusion was rare (1/151; 0.7%) and successfully treated with mechanical recanalization. Adjusted differences in clot length compared to Group A were 0.01 (-0.85 to 0.87) for Group B and -0.23 (-1.21 to 0.76) for Group C. Spline regression analysis showed no significant association between the flushing interval and clot length ( for trend = 0.84).
The incidence and burden of intraluminal clots did not increase significantly within the first 3 months. Occlusion was rare, even in the presence of clots, and was successfully treated. Therefore, a 3-month flushing interval appears to be a safe and practical option, aligning with the common recommendation for surveillance intervals in patients with cancer.
本研究旨在评估完全植入式静脉输液港（TIVAP）3个月冲洗间隔的安全性和可行性，特别是关于管腔内血栓形成方面。
在2017年5月至2018年9月期间，我们建立了一个单中心队列，纳入151例因TIVAP取出而转诊的患者，并将他们分为三个冲洗间隔组：A组（≤1个月）、B组（1 - 2个月）和C组（2 - 3个月）。使用逻辑回归计算比值比（OR）及95%置信区间（CI），以确定管腔内血栓发生的风险。为比较各组间血栓长度，我们采用线性回归。使用受限立方样条将冲洗间隔建模为连续变量。
与A组相比，B组和C组管腔内血栓风险的调整后OR分别为0.82（0.35 - 1.92）和0.78（0.29 - 2.11）。阻塞情况罕见（1/151；0.7%），并通过机械再通成功治疗。与A组相比，B组血栓长度的调整后差异为0.01（-0.85至0.87），C组为-0.23（-1.21至0.76）。样条回归分析显示冲洗间隔与血栓长度之间无显著关联（趋势P = 0.84）。
在最初3个月内，管腔内血栓的发生率和负担没有显著增加。阻塞情况罕见，即使存在血栓也能成功治疗。因此，3个月的冲洗间隔似乎是一个安全可行的选择，符合癌症患者监测间隔的普遍建议。
