Implantable port fibrin sheath review
Abstract:
Purpose: We summarized the findings, diagnosis, and outcomes of cases for which contrast examination of central venous access ports (CV-ports) were attempted to detect complications.
Materials and methods: Fifty-seven contrast examinations were attempted for 45 patients with 46 CV-ports (median, 162 days after implantation). Contrast examination was performed due to three suspicion catheter fractures or 54 CV-port dysfunctions (combinations of an absence of blood reflux on aspiration and 9 sufficient, 21 insufficient, or 24 impossible drip infusions).
Results: Contrast examination was successfully performed in 52 cases and revealed 45 normal findings, 5 pericatheter fibrin sheath formations, and 2 partial catheter fractures. In 23 of 45 cases with normal findings, the resistance to injection was initially mild or moderate but resolved after the CV-port was flushed slowly with heparinized saline solution. Subsequent contrast examination demonstrated normal findings. All fibrin sheath formations disappeared after thrombolytic therapy. Five cases could not undergo contrast examination due to high resistance. After contrast examination, nine of 46 CV-ports were removed or exchanged, while the use of the remaining 37 continued.
Conclusion: Contrast examination of CV-port allowed the assessment of suspected complications and early treatment.
Reference:
Iguchi T, Hiraki T, Matsui Y, Tomita K, Uka M, Umakoshi N, Kajita S, Komaki T, Gobara H, Kanazawa S. Contrast examination of central venous access port implanted through internal jugular vein for evaluation of suspected complications. Jpn J Radiol. 2021 May 22. doi: 10.1007/s11604-021-01142-4. Epub ahead of print. PMID: 34021855.