Central Vein Dilatation Prior to Concomitant Port Implantation

Journal Article · Thu Apr 15 04:00:00 EDT 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9699-Z· OSTI ID:21429026

Plumhans, Cedric; Goerg, Fabian; Guenther, Rolf W ^[1]

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1. University of Technology (RWTH) Aachen, Department of Diagnostic Radiology, University Hospital (Germany)

Implantation of subcutaneous port systems is routinely performed in patients requiring repeated long-term infusion therapy. Ultrasound- and fluoroscopy-guided implantation under local anesthesia is broadly established in interventional radiology and has decreased the rate of complications compared to the surgical approach. In addition, interventional radiology offers the unique possibility of simultaneous management of venous occlusion. We present a technique for recanalization of central venous occlusion and angioplasty combined with port placement in a single intervention which we performed in two patients. Surgical port placement was impossible owing to occlusion of the superior vena cava following placement of a cardiac pacemaker and occlusion of multiple central veins due to paraneoplastic coagulopathy, respectively. In both cases the affected vessel segments were dilated with balloon catheters and the port systems were placed thereafter. After successful dilatation, the venous access was secured with a 25-cm-long, 8-Fr introducer sheath, a subcutaneous pocket prepared, and the port catheter tunneled to the venipuncture site. The port catheter was introduced through the sheath with the proximal end connected to a 5-Fr catheter. This catheter was pulled through the tunnel in order to preserve the tunnel and, at the same time, allow safe removal of the long sheath over the wire. The port system functioned well in both cases. The combination of recanalization and port placement in a single intervention is a straightforward alternative for patients with central venous occlusion that can only be offered by interventional radiology.

• OSTI ID: 21429026
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 33; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
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CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
FLUOROSCOPY
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
TUBES
VEINS