Is radiologic placement of an arm port mandatory in oncology patients?: Analysis of a large bi-institutional experience

BACKGROUND. The objective of the current study was 2-fold: to evaluate a radio-logically placed percutaneous arm port device (PRAPD) in a large series of 1000 consecutive cancer patients undergoing chemotherapy (in terms of safety, efficacy, complications, and quality of life [QoL]) and to propose future recommendations. METHODS. From 1998 to August 2002, all patients who had cancer required chemotherapy underwent insertion of a PRAPD and were prospectively included. All patients were followed for technical feasibility, overall device-related complications, and QoL. RESULTS. Technical failures (6.3%) were caused by the inability to perform an arm venogram in 22 patients or to catheterize the brachial vein in 41 patients. Septic complications (3.2%) included septicemia (n = 7 patients), catheter sepsis (n = 9 patients), and febrile neutropenia (n = 16 patients). Mechanical complications (4%) included a twisted port (n = 2 patients), extravasation (n = 7 patients), catheter leaks (n = 7 patients), port obstruction (n = 7 patients), skin dehiscence of the port (n = 11 patients), catheter rupture and occlusion (n = 5 patients), and median nerve compression (n = I patient). Central venous thrombosis occurred in 12 patients (1.2%), and arm phlebitis occurred in 7 patients (0.7%). Procedure-related death occurred in 0.4%. Early port removal was performed in 5.3% of patients. Good QoL was reported at port removal. CONCLUSIONS. The PRAPD was found to be safe, effective, and well tolerated in oncology patients. PRAPD could be recommended in selected patients instead of a surgical port device.