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Dislodgment of port-a-cath catheters in children

Chi-Lin Ho1, Chia-Man Chou, Te-Kau Chang

  • 1Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.

Pediatrics and Neonatology
|January 13, 2009
PubMed

Insights

Port-a-cath catheter dislodgment in pediatric oncology patients is rare but serious. This study found an 4.1% dislodgment rate, with most catheters breaking at the port anastomosis, successfully retrieved using a gooseneck snare.

Area of Science:

  • Pediatric Surgery
  • Vascular Access Devices
  • Oncology

Background:

  • Port-a-cath catheters are essential for chemotherapy in pediatric cancer patients.
  • Catheter dislodgment, though infrequent, poses significant clinical risks.
  • This study reviews an 11-year experience with port-a-cath dislodgments in children.

Purpose of the Study:

  • To analyze the incidence and characteristics of port-a-cath catheter dislodgments in pediatric oncology patients.
  • To evaluate the outcomes of transcatheter retrieval for dislodged catheters.
  • To identify common failure points in port-a-cath systems.

Main Methods:

  • Retrospective analysis of 12 pediatric patients with port-a-cath dislodgment between June 1997 and January 2008.
  • Patients' ages ranged from 2-16 years (median 6.4), and weights from 12-39 kg (median 20).
  • Catheter retrieval was performed using a gooseneck snare.

Main Results:

  • The overall dislodgment rate was 4.1% among 290 implanted ports.
  • Dislodged catheter tips were found in the right heart chambers or pulmonary arteries.
  • Eleven of twelve catheters (83%) fractured at the port anastomosis site.

Conclusions:

  • Port-a-cath catheter dislodgment occurred at a rate of 4.1% in this pediatric oncology cohort.
  • Catheter breakage at the anastomosis is the primary failure mode.
  • Transcatheter retrieval with a gooseneck snare is a safe and effective treatment for dislodged catheters.
Abstract

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