A Comparative Study of Low-Profile and Regular Type Totally Implantable Venous Access Devices in Patients with Malignant Tumors: Retrospective Analysis of 4501 Implantations

The purpose of this study was to evaluate safety and efficacy of image-guided radiological totally implantable venous access devices with special reference to rate of skin complications of both regular and low-profile types. 4395 patients were referred to Interventional Radiology Unit between March 2003-September 2013. 4501 implantations of totally implantable venous access device were performed in patients under sonography and fluoroscopy. During this period 2299 regular-type and 2202 low-profile type totally implantable venous access devices were used. Success rate, periprocedural early and long-term complications were evaluated. Periprocedural and early complications of totally implantable venous access devices included 16 (0.4%) arterial punctures, 101(2.2%) minor hematoma, 1 (%0.02) disconnection of the catheter, 4 (0.09%) septum separation, 38(0.8%) minor erythema-pain and tenderness, 23 (0.5%) short term fever without bacteriemia and 25(0.6%) inversion of the port. Late complications included 6(0.1%) cellulitis, 8(0.2%) bacteriemia and sepsis, 305 (6.8%) venous thrombosis, 62 (1.4%) catheter thrombosis, 6 (0.1%) catheter migration and 3 (0.07%) catheter fracture. A total of 53 (1.18%) skin perforation were seen. There was statistically significant difference between regular and low-profile totally implantable venous access devices particularly in patients with normal and thinner subcutaneous fat tissue (p= 0.024 and <0.001 respectively). The present study is the largest series in the literature in patients with malignant tumors. Image-guided radiological totally implantable venous access device placement is safe and reliable method with a low risk of complications and the results of this study further justify the use of low profile totally implantable venous access device based on lower skin complications.