Complications of a Totally Implanted Vascular Access Device (Chemoport) in Children with Malignancy

Kim, Jung Ok; Lee, Ji Hye; Lee, Kun Soo

Abstract

BACKGROUND: Carefully using a totally implanted vascular access device and regular check-up of its condition in children who suffer with malignancy is very important. This study was performed to determine the complications related to using this device, according to the patient's age, gender and diagnosis, and the time from port insertion.
METHODS
We retrospectively studied 77 patients with malignancy (46 males and 31 females, age: 0.1~18 years, mean age: 7.8 years) and they were treated with a totally implanted vascular access device (chemoport) from January 1996 to May 2007 in Kyungpook National University Hospital, Korea. We assessed the symptoms and radiologic findings, conducted blood tests and doppler USG; we found several complications and compared them according the patients' age, gender and diagnosis.
RESULTS
Among the 77 cases with a totally implanted vascular access device (chemoport), 14 cases had complications related to the chemoport. Infections were detected in 8 cases. 6 of them had infections related to the chemoport after 4~7 months from the port-insertion. After port removal and treatment with broad spectrum antibiotics, their symptoms such as fever and swelling were improved. Disconnection of the port was detected in 2 cases after 2 months and 22 months from port-insertion, respectively. These ports were successfully removed by cardiac catheterization. Rotation of the port was detected in one case after 9 months from port-insertion: the rotated port was removed. Obstruction with thrombus was detected in 3 cases, after 7~16 months from port-insertion: this condition was treated with thrombolytic agents such urokinase and t-PA (tissue plasminogen activator), or surgical removal of the blood clot in the port site.
CONCLUSION
To reduce the complications related to the totally implanted vascular access (device), such as infection, thrombosis and disconnection, we should carefully use this device and also regularly check its function and position. After completion of chemotherapy, removal of the port as soon as possible should be considered. If a complication is detected, then we should manage it immediately.