Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008000400005
Jornal Vascular Brasileiro
Original Article

Perviedade e complicações no seguimento de cateteres venosos totalmente implantáveis para quimioterapia

Patency and complications in the follow-up of totally implantable catheters for chemotherapy

Robson Barbosa de Miranda; Jocefábia Reika Alves Lopes; Rafael Noronha Cavalcante; Ohannes Kafejian

http://dx.doi.org/10.1590/S1677-54492008000400005 J Vasc Bras, vol.7, n4, p.316-320, 2008
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Resumo

CONTEXTO: A disponibilidade de acesso venoso nos pacientes que recebem cursos prolongados de terapia citotóxica é de grande importância para o sucesso do tratamento. Os cateteres totalmente implantáveis vêm sendo cada vez mais utilizados para a referida terapia, proporcionando melhoria na qualidade de vida dos doentes. OBJETIVO: Avaliar a perviedade e complicações dos cateteres venosos totalmente implantáveis instalados nos pacientes oncológicos. MÉTODOS: Estudo longitudinal retrospectivo com 74 pacientes submetidos a colocação de cateter totalmente implantável de janeiro de 2004 a fevereiro de 2007. RESULTADOS: Foram inseridos cateteres venosos totalmente implantáveis em 74 pacientes com idade média 48,9 anos, predominando o sexo feminino. As neoplasias mais prevalentes foram mama (40,5%), cólon (20,8%) e linfoma (18,9%). Houve predomínio do acesso venoso pela via cervical (74,3%), com utilização da veia jugular interna em 45,9% dos casos. Somente 13,5% dos acessos ocorreram por punção da veia subclávia. A duração média de uso dos cateteres foi de 335,33 dias. Trinta e seis doentes (48,6%) mantiveram-se com o cateter após o término da quimioterapia. Sessenta e sete doentes (90,5%) não apresentaram complicações. Entre as complicações precoces, houve um (1,4%) pneumotórax e um (1,4%) hematoma na loja de implantação. Entre as complicações tardias, ocorreram cinco (6,7%) infecções. Foram retirados 10 (13,5%) cateteres, cinco devido às complicações e cinco por término do tratamento. Houve 11 (14,9%) óbitos de pacientes em decorrência do câncer, com o cateter funcionante. CONCLUSÃO: Os resultados obtidos demonstram baixa taxa de complicações, confirmando a segurança e conveniência do uso dos acessos totalmente implantáveis em paciente em regime de quimioterapia.

Palavras-chave

Quimioterapia, cateter implantável, infecção, qualidade de vida

Abstract

BACKGROUND: Availability of venous access for patients that receive long-term cytotoxic therapy is of great importance to the success of treatment. Totally implantable devices have been increasingly more used for this therapy, providing improvement in the quality of life of patients. OBJECTIVE: To evaluate patency and complications of totally implantable catheters inserted in oncological patients. METHODS: Retrospective longitudinal study of 74 patients that underwent placement of totally implantable catheter from January 2004 throughout February 2007. RESULTS: Totally implantable catheters were placed in 74 patients with mean age of 48.9 years; the female gender was predominant. The most prevalent neoplasms were breast (40.5%), colon (20.8%) and lymphoma (18.9%). Cervical access (74.3%) was prevalent, using the internal jugular vein in 45.9% of cases. Only 13.5% of accesses were inserted via subclavian vein puncture. Mean duration of catheter use was 335.33 days. Thirty six (48.6%) patients remained with the catheter after the chemotherapy was discontinued. There were no complications in 67 (90.5%) patients. Among early complications, there was one (1.4%) pneumothorax and one (1.4%) hematoma. Among late complications, there were five (6.7%) infections. Ten (13.5%) catheters were removed, five due complications and five after ending the treatment. Eleven (14.9%) patients died from cancer, and the catheters were still functioning. CONCLUSION: The outcomes obtained show low rate of complications, confirming that use of totally implantable catheters is safe and effective for patients undergoing chemotherapy.

Keywords

Chemotherapy, implantable catheters, infection, quality of life

References

Biffi R, Pozzi S, Agazzi A. Use of totally implantable central venous access ports for high-dose chemotherapy and peripheral blood stem cell transplantation: results of a monocentre series of 376 patients. Ann Oncol. 2004;15:296-300.

Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet. 1973;136:602-6.

Hickman RO, Buckner CD, Clift RA, Sanders JE, Stewart P, Thomas ED. A modified right atrial catheter for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet. 1979;148:871-5.

Wolosker N, Yazbek G, Nishinari K. Totally implantable venous catheters for chemotherapy: experience in 500 patients. São Paulo Med J. 2004;122:147-51.

Kapadia S, Parakh R, Grover T, Yadav A. Catheter fracture and cardiac migration of a totally implantable venous device. Indian J Cancer. 2005;42:155-7.

Di Carlo I, Cordio S, La Greca G. Totally implantable venous access devices implanted surgically: a retrospective study on early and late complications. Arch Surg.. 2001;136:1050-3.

Kurul S, Saip P, Aydin T. Totally implantable venous-access ports: local problems and extravasation injury. Lancet Oncol. 2002;3:684-92.

Freytes CO. Indications and complications of intravenous devices for chemotherapy. Curr Opin Oncol. 2000;12:303-7.

Sandhu J. Dialysis ports: A new totally implantable option for hemodialysis access. Tech Vasc Interv Radiol. 2002;5:108-13.

Freytes CO, Reid P, Smith KL. Long-term experience with a totally implanted catheter system in cancer patients. J Surg Oncol. 1990;45:99-102.

Gyves JW, Ensminger WD, Niederhuber JE. A totally implanted injection port system for blood sampling and chemotherapy administration. JAMA. 1984;251:2538-41.

Carde P, Cosset-Delaigue MF, Laplanche A, Chareau I. Classical external indwelling central venous catheter versus totally implanted venous access systems for chemotherapy administration: a randomized trial in 100 patients with solid tumors. Eur J Cancer Clin Oncol. 1989;25:939-44.

Vanek VW. The ins and outs of venous access: Part I. Nutr Clin Pract. 2002;17:85-98.

Hackert T, Tjaden C, Kraft A, Sido B, Dienemann H, Buchler MW. Inatrapulmonal dislocation of a totally implantable venous access device. World J Surg Oncol.. 2005;11:3-19.

Chang HM, Hsieh CB, Hsieh HF. An alternative technique for totally implantable central venous access devices: A retrospective study of 1311 cases. Eur J Surg Oncol. 2006;32:90-3.

Charvát J, Linke Z, Horáèková M, Prausová J. Implantation of central venous ports with catheter insertion via the right internal jugular vein in oncology patients: single center experience. Support Care Cancer. 2006;14:1162-5.

Van Den Akker-Berman LM, Pinzur S, Aydinalp A. Uneventful 25-year course of an intracardiac intravenous catheter fragment in the right heart. J Interv Cardiol.. 2002;15:421-3.

Wolosker N, Yazbek G, Munia MA, Zerati AE, Langer M, Nishinari K. Totally implantable femoral vein catheters in cancer patients. Eur J Surg Oncol. 2004;30:771-5.

Koldehoff M, Zakrzewski JL. Taurolidine is effective in the treatment of central venous catheter-related bloodstream infections in cancer patients. Int J Antimicrob Agents. 2004;24:491-5.

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