Complications of transfemoral removal of percutaneous transfemorally implanted port-catheter systems

Abstract

Our purpose is to evaluate the feasibility and safety of the withdrawal procedure of percutaneous transfemorally implanted port-catheter systems. Thirty-seven patients (17.7%) underwent the withdrawal procedure of this port-catheter system among 209 patients. The reasons for withdrawal were as follows: termination of intra-arterial chemotherapy (n = 7), obstruction of hepatic artery (n = 5), port infection (n = 4), catheter infection (n = 4), catheter obstruction (n = 4), lower-limb palsy and pain (n = 2), exposure of the port due to skin defect (n = 2), patient's desire (n = 2), side effect of chemotherapy (n = 1), no effectiveness of chemotherapy (n = 1), hematoma at the puncture site (n = 1), duodenum perforation by the catheter (n = 1), intermittent claudication due to severe stenosis of right common iliac artery (n = 1), dissection of common hepatic artery (n = 1), and broken catheter (n = 1). In thirty-four of the 37 cases, the port-catheter system was successfully withdrawn without any complications. Clinical success rate was 91.9%. Complications occurred in three cases (8.1%), which were a pseudoaneurysm, thromboembolism of the right common iliac artery, and continuous bleeding from the subcutaneous pocket where the port system was placed for 1 month. In 15 cases, correction of the catheter tip or exchange for dislocation of the tip had to be done without withdrawal. It is not rare to withdraw port-catheter systems in cases of infection or hematoma around the system. Although withdrawal of a percutaneous transfemorally implanted port-catheter system is a relatively safe procedure, the port-catheter system should not be removed unless absolutely indicated.