Onkológia 6/2022
Our experience with central venous access device insertion
Background: Systemic antineoplastic therapy is delivered mostly intravenously. Many of these drugs are not suitable for delivery through peripheral i.v. lines (i.e. vesicants, irritants). Long-term central venous access devices (CVADs) allow for safer and repeated administration of these drugs and supportive therapy and can also be used for blood sampling. Therefore they can have positive impact on patient´s quality of life. Because of these advantages we began insertion of long-term CVADs in 2019 at National Cancer Institute in Bratislava. In this article we describe the progress of our central venous access team and we evaluate a our cohort of patients. Patients and methods: We retrospectively evaluated a cohort of patients with long-term CVAD inserted in the year 2021 at four departments of the National Cancer Institue in Bratislava. Follow-up period was until May 16, 2022. We evaluated duration of CVAD, complication rate, reasons for CVAD removal and deep vein thromboses in subgroups of patients according to their diagnoses. Results: We inserted 240 long-term CVADs at 4 departments of our hospital in the year 2021. We evaluated 225 of them. Fifteen CVADs we not eligible for evaluation because we were unable to obtain sufficient data. Median duration of CVAD was 144 days. Complication rate was 15% which represents 0,97 complications per 1000 catheter-days. We extracted 10,2% CVADs due to complications. We removed 60,9% of catheters because they were no longer necessary. There were 28,9% catheters still in use at the end of follow-up. Due to low number of deep vein thromboses our subgroup analysis didn´t reach statistical significance. Conclusion: Our results show that long-term CVADs are a safe way to administer antineoplastic chemotherapy. Our CVAD complication rates are comparable to those of other cannulation teams even abroad.
Keywords: experience, central venous access, central venous catheter, PICC, CICC, port-a-cath, insertion, trial
