Discussion Author: Ralph H Pickard
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:
Brachial nerve injury
Tunnel or port infection/sepsis
Loss of catheter function (fibrin sheath/ball-valve effect)
Device/catheter migration (port flipping)
Damaged/leaking catheters (extravasation)
Superior Vena Cava erosion
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