Peripheral venous access ports: Outcomes analysis in 109 patients

Purpose: To perform a retrospective outcomes analysis of central venous cat heters with peripheral venous access ports, with comparison to published da ta. Methods: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemother apy, hyperalimentation, long-term antibiotic therapy, gammaglobulin therapy , and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium . Povidone iodine skin preparation was used in the first 65 port insertions . A combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) war farin sodium beginning the day after port insertion. Three patients receive d higher doses of warfarin sodium for preexistent venous thrombosis. Cathet er performance and complications were assessed and compared with published data. Results: Access into the basilic or brachial veins was obtained in all case s. Ports remained functional for a total of 28,936 patient days. The port f unctioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of pat ients. Eleven patients (9.9% of ports placed) suffered an infectious compli cation (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three p atients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfar in sodium and in two patients (3%) not receiving warfarin sodium. This diff erence was not statistically significant (p = 0.6). Aspiration occlusion oc curred in 13 patients (11.7%). Intracatheter urokinase was infused in eight of these patients and successfully restored catheter function in all but t wo instances. These complication rates are comparable to or better than tho se reported with chest ports. Conclusion: Peripheral ports for long-term central venous access placed by interventional radiologists in the interventional radiology suite are as sa fe and as effective as chest ports.