Complications of port-catheter systems in intra-arterial infusion chemotherapy

The complications associated with the placement and use of 252 modified Port-A-Cath systems and 24 Jet Port systems (PFM, FRG) in 266 cancer patients, who received arterial infusion chemotherapy during a 31-month period, were analyzed. The Port-A-Cath (Pharmacia, USA) was connected to a Teflon catheter (Sharp, Japan) for infusion therapy of various regional malignancies. Complications necessitating reoperation are grouped in two categories: port-catheter occlusions and local wound complications. Those related to port-catheter occlusions (n=76, 28%) leading to catheter rupture occured in 55, disconnection between the port and the catheter in 16, and luxation of the port in 5. Local wound complications (n=20,7%) encountered were wound dehiscence in 12, thinning of the skin over the port in 4, puncture-site skin necrosis in 2, pocket skin necrosis in 1 and port rotation in 1. All these complications can be easily dealt with without any serious consequences. Most of the above complications can be avoided by using an adequately designed port-catheter system, proper handling by the expert, and use of a suitable heparin.