Safety and Efficacy of Image-Guided Totally Implanted Central Venous Catheter Insertion in Cancer Patients

Abstract

Background and Objective:Repetitive administration of the antineoplastic agents through peripheral veins eventually destroys venous integrity and decreases the ability to obtain venous access. We conducted this study to determine the safety and efficacy of totally implanted central venous catheters (TIVADs) in the administration of chemotherapy and to detect the advantages of using ultrasound and fluoroscopy to insert (TIVADs).Methods:The study enrolled 104 cancer patients who received image-guided, totally implanted port insertion in the period from October 2019 to September 2023 at the interventional radiology units.All patients were analyzed prospectively regarding their characterization, technical factors, patency, and acute and late complications during device implantation.Results:We reported a 100% insertion success rate. The total complication rate was 13.5% (n=14), divided into early complications (within 30 days of the procedure) developed in 2.9% (n=3) of the patients, and late complications occurred later on in 10.6% (n=11) of the cases.The most observed complication was port pocket infection, which occurred in 4.8% (n=5) of the patients. Catheter dysfunction due to late catheter-related central venous thrombosis was observed in 3.8% (n=4) of the cases. Catheter-related bloodstream infection, chemotherapy extravasation, mechanical dysfunction due to catheter kink, wound dehiscence, and skin necrosis; each of these complications occurred once in our study.Conclusion:Image-guided insertion of totally implanted venous access devices (TIVADs) showed high technical and clinical success rates with low complication rates, which could provide safe, practical, and life-long venous access for the administration of cytotoxic agents.