TY - JOUR
T1 - GAVeCeLT* consensus statement on the correct use of totally implantable venous access devices for diagnostic radiology procedures
AU - Bonciarelli, G
AU - Batacchi, S
AU - Biffi, R
AU - Buononato, M
AU - Damascelli, B
AU - Ghibaudo, F
AU - Orsi, F
AU - Pittiruti, Mauro
AU - Scoppettuolo, Giancarlo
AU - Verzè, A
AU - Borasi, G
AU - De Cicco, M
AU - Dosio, R
AU - Gazzo, P
AU - Maso, R
AU - Roman, A
AU - Ticha, V
AU - Venier, G
AU - Blackburn, P
AU - Goossens, Ga
AU - Bowen Santolucito, J
AU - Stas, M
AU - Van Boxtel, T
AU - Vesely, Tm
AU - De Lutio, E.
PY - 2011
Y1 - 2011
N2 - The use of totally implantable venous access devices in radiology may be associated with complications such as occlusion of the system (because of the high density of some contrast), infection (if the port is not handled in aseptic conditions, using proper barrier protections), and mechanical complications due to the high-pressure administration of contrast by automatic injectors (so-called power injector), including extravasation of contrast media into the soft tissues, subintimal venous or myocardial injection, or serious damage to the device itself (breakage of the external connections, dislocation of the non-coring needle, or breakage of the catheter). The last problem - i.e., the damage of the device from a power injection - is not an unjustified fear, but a reality. A warning by the US Food and Drug Administration of July 2004 reports around 250 complications of this kind, referring to both port and central venous catheters and peripherally inserted central catheter systems, which occurred over a period of several years; in all cases, the damage occurred during the injection of contrast material by means of power injectors for computed tomography or magnetic resonance imaging procedures. Though the risk associated with the use of ports in radiodiagnostics is thus clear, it has been suggested that administration of the contrast material via the port may have some advantage in terms of image quality, increased comfort for the patient, and maybe more accurate reproducibility of the patient's own follow-up exams. This contention needs to be supported by evidence. Also, since many cancer patients who need frequent computed tomography studies already have totally implantable systems, it would seem reasonable to try to define how and when such systems may safely be used. The purpose of this consensus statement is to define recommendations based on the best available evidence, for the safe use of implantable ports in radiodiagnostics.
AB - The use of totally implantable venous access devices in radiology may be associated with complications such as occlusion of the system (because of the high density of some contrast), infection (if the port is not handled in aseptic conditions, using proper barrier protections), and mechanical complications due to the high-pressure administration of contrast by automatic injectors (so-called power injector), including extravasation of contrast media into the soft tissues, subintimal venous or myocardial injection, or serious damage to the device itself (breakage of the external connections, dislocation of the non-coring needle, or breakage of the catheter). The last problem - i.e., the damage of the device from a power injection - is not an unjustified fear, but a reality. A warning by the US Food and Drug Administration of July 2004 reports around 250 complications of this kind, referring to both port and central venous catheters and peripherally inserted central catheter systems, which occurred over a period of several years; in all cases, the damage occurred during the injection of contrast material by means of power injectors for computed tomography or magnetic resonance imaging procedures. Though the risk associated with the use of ports in radiodiagnostics is thus clear, it has been suggested that administration of the contrast material via the port may have some advantage in terms of image quality, increased comfort for the patient, and maybe more accurate reproducibility of the patient's own follow-up exams. This contention needs to be supported by evidence. Also, since many cancer patients who need frequent computed tomography studies already have totally implantable systems, it would seem reasonable to try to define how and when such systems may safely be used. The purpose of this consensus statement is to define recommendations based on the best available evidence, for the safe use of implantable ports in radiodiagnostics.
KW - Catheterization, Central Venous
KW - Catheters, Indwelling
KW - Contrast Media
KW - Equipment Design
KW - Equipment Failure
KW - Humans
KW - Injections
KW - Magnetic Resonance Imaging, Interventional
KW - Patient Safety
KW - Predictive Value of Tests
KW - Pressure
KW - Radiography, Interventional
KW - Risk Assessment
KW - Risk Factors
KW - Catheterization, Central Venous
KW - Catheters, Indwelling
KW - Contrast Media
KW - Equipment Design
KW - Equipment Failure
KW - Humans
KW - Injections
KW - Magnetic Resonance Imaging, Interventional
KW - Patient Safety
KW - Predictive Value of Tests
KW - Pressure
KW - Radiography, Interventional
KW - Risk Assessment
KW - Risk Factors
UR - http://hdl.handle.net/10807/63476
U2 - 10.5301/JVA.2011.7736
DO - 10.5301/JVA.2011.7736
M3 - Article
SN - 1724-6032
VL - 12
SP - 292
EP - 305
JO - THE JOURNAL OF VASCULAR ACCESS
JF - THE JOURNAL OF VASCULAR ACCESS
ER -