John Libbey Eurotext

Bulletin du Cancer


Complications thrombotiques des chambres à cathéter implantables : évaluation prospective Volume 91, issue 5, Mai 2004

CHU, Avenue Martin‐Luther‐King, 87042 Limoges

Implanted venous access devices (IVAD) are routinely used in oncologic patients. Thrombotic complication is a source of morbidity. During one year 246 patients with different solid neoplastic diseases received IVAD for chemotherapy administration. Two hundred forty‐nine IVAD were placed percutaneously or by surgical cutdown. IVAD were flushed immediately after implantation with 3‐5 mL of heparinized saline (100 U\mL). No monthly flush was required. A prospective evaluation of thrombotic complications was realised. In event of catheter dysfunction and\or clinical symptoms of phlebitis, a catheter opacification and\or a Doppler ultrasonography were performed. Twenty‐three catheter dysfunctions were noted, corresponding to 13 catheter occlusions. Twelve patients presented clinical symptoms of phlebitis. Eleven venous thrombosis were diagnosed in this group; 10 by echo‐Doppler and one by scanography. A unvaried statistic analysis using Fisher’s test was performed to detect risk factors. Two factors were identified: the position of catheter tip above T4 (p < 0.001) and mediastinal or cervical lymph nodes larger than 6 cm (p < 0.001). The first increased the risk of catheter occlusion and the second increased the risk of phlebitis.