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Fibrin sleeve formation after long term brachial catheterisation with an implantable port device. A prospective venographic study.

OBJECTIVE
To evaluate the risk of thrombosis after long term venous access with an implantable port device (PAS-Port system).


DESIGN
Open study.


SETTING
University Hospital, Linköping, Sweden.


SUBJECTS
Sixteen patients who required central venous catheters for long term chemotherapy were prospectively followed for 218 patient months (median 12.5 months/patient, range 3-34).


INTERVENTIONS
Venogram taken while the catheters were being withdrawn. Venography was also done in 10 patients 1-29 months after the catheter had been removed.


RESULTS
The venograms showed that fibrin sleeves had developed along the route of the catheter in all cases (cubital vein to the superior vena cava n = 7; to subclavian vein alone n = 8; and basilic vein alone n = 1). One of the 10 patients who underwent venography 1-29 months later had developed an occlusive subclavian vein thrombosis with well developed collateral vessels 10 months after the catheter had been removed.


CONCLUSION
Because of the high incidence of formation of extensive fibrin sleeves, implantable port devices should be removed as soon as they have served their purpose. If catheters malfunction they should be evaluated radiographically.