Venous access ports

Indications, implantation technique, follow-up, and complications

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

The subcutaneous venous access device (SVAD or "port") is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient's lifestyle. Because of improved materials and catheter technology, today's ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist of catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.

Original languageEnglish (US)
Pages (from-to)751-764
Number of pages14
JournalCardioVascular and Interventional Radiology
Volume35
Issue number4
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Catheters
Veins
Infection
Catheter-Related Infections
Interventional Radiology
Vascular Access Devices
Aptitude
Pneumothorax
Punctures
Catheterization
Hematoma
Life Style
Cardiac Arrhythmias
Patient Care
Thrombosis
Chronic Disease
Guidelines
Technology
Pressure
Costs and Cost Analysis

Keywords

  • Central venous catheterization
  • Venous port system
  • Venous thrombosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Venous access ports : Indications, implantation technique, follow-up, and complications. / Walser, Eric.

In: CardioVascular and Interventional Radiology, Vol. 35, No. 4, 08.2012, p. 751-764.

Research output: Contribution to journalArticle

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