Rofo 2011; 183(3): 260-266
DOI: 10.1055/s-0029-1245879
Interventionelle Radiologie

© Georg Thieme Verlag KG Stuttgart · New York

Angiografische Diagnostik und Interventionelle Therapie von Portdysfunktionen

Interventional Radiological Imaging and Treatment of Port Catheter DysfunctionsS. Kausche1 , S. N. Nagel1 , U. Teichgräber1
  • 1Institut für Diagnostische und Interventionelle Radiologie, Charité Universitätsmedizin Berlin
Further Information

Publication History

eingereicht: 16.5.2010

angenommen: 16.10.2010

Publication Date:
20 December 2010 (online)

Zusammenfassung

Ziel: Evaluation der interventionsradiologischen Darstellung und Behebung von Portdysfunktionen. Material und Methoden: Es erfolgte die retrospektive Auswertung von 429 Portdarstellungen an 393 Portkathetersystemen bei insgesamt 389 Patienten über einen Zeitraum von 10 Jahren. Einbezogen wurden sowohl die intern radiologisch implantierten Portsysteme, 193 (49,1 %), als auch die zur Portdarstellung überwiesenen Patienten mit chirurgisch implantierten Portsystemen, 200 (50,9 %). Portkatheterdysfunktionen wurden in Früh- und Spätkomplikationen sowie in thrombotische und nicht thrombotische Ereignisse unterteilt. Die Portdarstellung erfolgte nach Gabe von Kontrastmittel in digitaler Subtraktionsangiografie (DSA). Ergebnisse: Es zeigten sich 359 (83,7 %) Spätkomplikationen sowie 70 (16,3 %) Frühkomplikationen. In 299 (69,7 %) Fällen traten thrombotische Ereignisse auf, nicht thrombotische Ereignisse wurden 130 (30,3 %) mal verzeichnet. Häufigster Grund für die Portkatheterdarstellung war die katheterassoziierte Thrombose mit insgesamt 269 (62,7 %) Fällen. 70 (16,3 %) Kathetermigrationen und 30 (7,0 %) Fibrinummantelungen wurden dargestellt. 18 (4,2 %) Portnadeldefekte konnten durch Austausch der Nadel behoben werden. Alle 15 (3,5 %) Katheterdiskonnektionen erforderten die Revision des Portsystems. Die ebenfalls vollständige Explantation erfolgte bei 6 (1,4 %) Katheterfrakturen. Schlussfolgerung: Die Möglichkeiten der angiografischen Darstellung und die interventionsradiologische Behebung von Portkatheterdysfunktionen müssen im vollen Umfang ausgenutzt werden, um eine vorzeitige Portexplantation zu vermeiden.

Abstract

Purpose: To evaluate the impact of interventional radiological imaging and treatment of central venous port catheter complications. Materials and Methods: In this retrospective analysis 429 port catheter dysfunctions were evaluated in 393 port catheter systems for a total of 389 patients over a period of 10 years. The study included 193 (49.1 %) patients with radiologically implanted port catheter systems and 200 (50.9 %) referred patients with surgically implanted port systems. Port catheter dysfunctions were subdivided into early and late complications as well as into non-thrombotic and thrombotic events. After administration of contrast medium, the port system was visualized using digital subtraction angiography. Data were retrospectively collected from the in-house databases and then analyzed descriptively. Results: 429 contrast media injections via port catheters were performed in 393 port catheter systems. There were 359 (83.7 %) late complications and 70 (16.3 %) early complications. In 299 (69.7 %) cases thrombotic events occurred and 130 (30.3 %) non-thrombotic events were recorded. The most common reason for contrast media injection via port catheter system was port catheter-related thrombosis in 269 (62.7 %) cases. 70 (16.3 %) catheter migrations and 30 (7.0 %) fibrin sheath formations were detected. 18 (4.2 %) port needle malfunctions could be resolved through needle exchange. All 15 (3.5 %) catheter disconnections had to be revised in all cases. Also six port explantations were performed in 6 (1.4 %) catheter fractures. Conclusion: The possibilities of angiographic imaging and interventional radiological correction of port catheter dysfunctions must be exploited fully in order to avoid premature port explantation.

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Priv.-Doz. Dr. Ulf Teichgräber

Institut für Diagnostische und Interventionelle Radiologie, Charité Universitätsmedizin Berlin

Charitéplatz 1

13353 Berlin

Phone: ++ 49/30/4 50 55 72 98

Fax: ++ 49/30/4 50 55 79 07

Email: ulf.teichgraeber@charite.de