Malfunction of totally implantable central venous ports

Abstract

Background: Malfunctions of totally implantable central venous ports (TICVPs) have become a problem, as the usage of TICVPs has increased enormously. Objectives: This study evaluated factors related with catheter malfunctions of TICVPs. Patients and Methods: Between January 2010 and June 2012, 1,740 TICVPs in 1,740 patients (874 men and 866 women) with an average age of 57.7±12.8 years (range: 15 - 91 years) were implanted by an interventional radiology team at our institute. Catheter malfunctions were retrospectively analyzed. In the prospective study, we randomly allocated 176 patients to two kinds of TICVPs in a 1:1 assignment ratio. The primary outcome was the malfunction of TICVPs. Results: In the retrospective study, the 32 malfunctioning TICVPs were caused by fibrin sheath formations (n = 15), chamber thrombosis (n = 8), TICVP rotation (n = 5), catheter migration (n = 2), and blood clots within the catheters (n = 2). Multivariate analysis showed that being female was a significant factor for poor patency rates of TICVPs (hazard ratio: 5.06; 95% confidence interval (CI) 1.32 - 19.46, P = 0.018). In the prospective study, two chamber thromboses occurred in Celsite® (n = 1) and Humanport® (n = 1). The primary patency rates of both Celsite® and Humanport® were 98.9% at 6 months, respectively. Conclusion: Our data suggest that catheter malfunctions of TICVPs are more common in females than males. The incidence of TICVP malfunctions does not differ between the two devices (Celsite® vs. Humanport®).