Outpatient implantation of a central venous access system in gynecologic oncology patients

OBJECTIVE: To determine the feasibility, accuracy, complications and cost of implantation of the PORT-A-CATH® II Fluoro-Free® venous access system (SIMS Deltec Inc., St. Paul, Minnesota) in the procedure room setting. STUDY DESIGN: A prospective study of 49 consecutive gynecologic oncology patients who undenvent 53 PORT-A-CATH® II System implantations was conducted. Local anesthesia and conscious sedation were used for the procedure. To localize and position the catheter tip, the CATH-FINDER® (SIMS Deltec) electronic catheter sensing device was utilized. Demographic characteristics, operative data, complication rates, failure rates and itemized costs were collected and analyzed. RESULTS: For the 53 ports implanted, the mean operative time was 54 minutes (range, 39-74) and mean estimated blood loss was 17 mL (range, 7-50). Immediate complications included failure to thread the catheter or guidewire past the left subclavian vein (4 patients), pneumothorax (1) and electronic wire fracture (1). All catheter tips were positioned accurately, as confirmed by chest radiography. The procedural charge ranged from $1,946 to $2,042. The CATH-FINDER® obviated the need for, and expenses of, fluoroscopy, operating room and anesthesia services, resulting in savings of approximately $2,000 per procedure. CONCLUSION: Implantation of the PORT-A-CATH® II System was performed safely, accurately and cost effectively in the procedure room setting. The advantages of functional longevity, low complication rates and reduced cost of this port system offer an excellent option for long-term central venous access.