Port-a-Cath-related complications in 252 patients with solid tissue tumours and the first report of heparin-induced delayed hypersensitivity after Port-a-Cath heparinisation

Eur J Cancer Care (Engl). 2013 Jan;22(1):125-32. doi: 10.1111/ecc.12008. Epub 2012 Sep 11.

Abstract

The use of the subcutaneous Port-a-Catheters (Port-a-Caths) provides an important mean of venous access for oncological patients. The aim of our retrospective consecutive single-centre study was to investigate Port-a-Cath-related complications in 252 cancer patients. Overall period of Port-a-Caths maintenance was 25 months. The strategy of our centre is to keep Port-a-Caths in situ up to the end of follow-up in adjuvant cancer patients. A total of 22 complications were recorded (8.73%). Interventional complications occurred in four patients. The main complications during Port-a-Cath use included thrombosis (4 patients, 1.58%), infections (4 patients, 1.58%), persistent pain or discomfort (3 patients, 1.19%) and dislocations (2 patients, 0.79%). Median time to the occurrence of any type of complications was 4.5 months. Eleven Port-a-Caths were removed due to complications (4.36%). Similar rate of Port-a-Cath-related thrombosis/infection was seen in adjuvant and advanced cancer patients (no statistical significance). Continuous infusion of anticancer therapy via a Port-a-Cath system is a relatively safe procedure, although major complications might occur. We are first to describe heparin-induced delayed hypersensitivity after heparinisation of Port-a-Cath. This fact should influence the preference to keep the Port-a-Cath after completion of adjuvant anticancer treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Antineoplastic Agents / administration & dosage
  • Central Venous Catheters / adverse effects*
  • Female
  • Heparin / administration & dosage
  • Heparin / adverse effects*
  • Humans
  • Hypersensitivity, Delayed / chemically induced*
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Perioperative Period
  • Postoperative Complications
  • Retrospective Studies
  • Young Adult

Substances

  • Anticoagulants
  • Antineoplastic Agents
  • Heparin