Long term outcomes of implantable central venous access devices (chemoports) in patients with malignancies: A prospective observational study.

Abstract

e23349 Background: Central venous access devices (CVADs) play a critical role in the delivery of long-term intravenous therapy in oncology. Despite advances in device design and maintenance, chemoport related complications particularly infections remain clinically relevant, with limited prospective data from India and other low and middle income countries. This study evaluated the indications, complications, and outcomes associated with chemoport use in patients with malignancies. Methods: This prospective observational study was conducted over 18 months at the Department of Medical Oncology, Apollo Hospital International Ltd, India. Fifty consecutive patients with histologically confirmed malignancies undergoing chemoport insertion were enrolled. All devices were placed under ultrasound guidance, followed by routine post-procedure chest radiography. Patients were assessed for indications of chemoport insertion, underlaying malignancy and prospectively monitored for catheter care, complications, and outcomes. Complications were categorised as infectious, mechanical, procedure-related, thrombotic or other. Results: Fifty patients were included, with a mean age of 51.7 ± 18.7 years (range, 4–80); 74% were female. Breast cancer was the most common diagnosis (36%), followed by colorectal (18%), gynecologic (10%), sarcoma (6%), and hepatobiliary malignancies (6%). Infusional chemotherapy was administered in 98% of patients. The mean duration of catheter use was 8.4 months (range, 15 days–18 months). The right internal jugular vein was the most frequently used access site (84%). Across 983 catheter-days, six complications were observed, corresponding to a rate of 6.1 per 1,000 catheter-days. Mechanical complications occurred in two patients (4%). Infectious complications were documented in four patients (8%), including catheter-associated bloodstream infection (n=3) and port-site infection (n=1). Isolated organisms included Escherichia coli and Staphylococcus species. Infections resolved with conservative management in three patients; catheter removal was required in one patient. No immediate post-procedure complications were noted. Conclusions: Chemoport use demonstrated a favourable safety profile with a low complication rate in patients with malignancies. Infection was the most frequent complication, underscoring the importance of meticulous aseptic technique and vigilant catheter surveillance to minimize adverse events.