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Peripherally-placed central venous access ports: clinical and laboratory observations
1Department of Surgery, University of Mississippi Medical Center, Jackson 39216.
The American Surgeon
|December 1, 1994
Summary
The P.A.S. Port system offers a safe and effective alternative for central venous access, simplifying implantation and demonstrating low complication rates in forearm placement. This totally implantable device provides exceptional patient acceptance and durability.
Area of Science:
- Medical Devices
- Vascular Surgery
- Oncology
Background:
- Central venous access devices (CVADs) are crucial for long-term therapies but conventional chest-port systems can be invasive.
- Forearm implantation of CVADs presents an alternative to thoracic placement, potentially simplifying procedures and improving patient comfort.
- The P.A.S. Port system is a specific device designed for peripheral venous access, requiring evaluation for safety and efficacy.
Purpose of the Study:
- To evaluate the safety, efficacy, and patient acceptance of the P.A.S. Port system for totally implantable central venous access.
- To compare the P.A.S. Port system with conventional chest-placed devices regarding implantation, complications, and performance.
- To assess the feasibility of outpatient placement under local anesthesia without fluoroscopy.
Main Methods:
- A retrospective analysis of 61 P.A.S. Port devices implanted in 56 patients (age 9 months to 85 years).
- Follow-up data collected for a median of 672 days, monitoring complication rates, infection rates, and device patency.
- In vitro testing of infusion pressure compared between the P.A.S. Port and conventional catheter systems.
Main Results:
- A low overall complication rate of 13.1% and an infection rate of 6.6% were observed.
- Median event-free patency was 278 days, indicating durable function.
- Outpatient placement under local anesthesia was successful, without the need for fluoroscopy or a traditional operating room.
- In vitro infusion pressures were higher in the P.A.S. Port but remained clinically insignificant at clinically relevant flow rates.
Conclusions:
- The P.A.S. Port system is a safe, durable, and effective alternative for central venous access, particularly when chest-placed devices are unsuitable.
- Its simplified outpatient implantation and favorable complication profile contribute to exceptional patient acceptance.
- Forearm placement of the P.A.S. Port system offers a viable alternative to conventional thoracic CVADs.