MedPix® Medical Image DatabaseDisease Topic 2705
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Contributor: Ralph H Pickard - National Capital Consortium
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More Like This ? Indwelling Venous Access Devices
Factoid 2705 - Created: 2001-08-21 21:42:01-04 - Modified: 2001-08-23 07:52:39-04
ACR Codes: 56.461
Indwelling venous access devices such as tunneled catheters, dialysis catheters, peripherally inserted central catheters (PICC lines), and subcutaneous venous access devices (ports) have been available for more than 20 years. They have drastically improved comfort and convenience associated with the administration of chemotherapy and other intravenous therapies.

Tunnelled central catheters and implantable ports are commonly placed if long-term (more than a few months) IV therapy is required. Examples of tunnelled catheters are Groshong, Broviac, and Hickman catheters. Subcutaneous venous access devices (ports) are commonly located in the arm or chest.

Complications with these devices is relatively common with some studies reporting as high as a 78% complication rate. More commonly a complication rate of between 22% and 54% is experienced.

Complications associated with the initial placement and long term use of these devices include:
   Pneumothorax/hemothorax
   Brachial nerve injury
   Air embolus
   Cardiac arrythmias
   Tunnel or port infection/sepsis
   Venous thrombosis
   Loss of catheter function (fibrin sheath/ball-valve effect)
   Device/catheter migration (port flipping)
   Damaged/leaking catheters (extravasation)
   Superior Vena Cava erosion
Reference(s):
Wojtowycz M. Handbook of Interventional Radiology and Angiography. Second Edition, 1995; pp 167-171.

Young C, Gould JR. The Timing and Sequence of Multiple Device-related complications in patients with indwelling Subcutaneous Ports. Am J Surg, 1997 Oct;174(4):417-21

Eastridge BJ, Lefor AT. Complications of Indwelling Venous Access Devices in Cancer Patients. J Clin Oncol. 1995 Jan;13(1):233-8
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Prepared by: Ralph H Pickard
Affiliation: National Capital Consortium - || - Author Profile
Approved by: David S. Feigin, M.D.
Affiliation: Johns Hopkins Hospitals - || - Editor Profile
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