Femoral placement of totally implantable venous power ports as an alternative implantation site for patients with central vein occlusions

PURPOSE: To evaluate the indication, technical success, clinical outcome and safety of percutaneously placed totally implantable venous power ports (TIVPPs) in a femoral position in patients with contraindications to implantation in a standard position.

METHODS: Retrospectively, we screened our interventional radiology department database between 12/2,009 and 3/2,013 to identify 1,729 patients with a port implantation. In 8/1,729 (0.47 %) patients (1 male, 7 female, mean age 55.5 ± 9.6 years) the TIVPP was implanted via the common femoral vein with the port placed in the anterior thigh. All devices were high-pressure injectable, implanted under local anaesthesia with sonographic as well as fluoroscopic guidance, and were tunnelled subcutaneously. Indication, technical success and complications were retrospectively analysed according to the Society of Interventional Radiology (SIR) criteria.

RESULTS: Indications were planned chemotherapy for breast (n = 6) and oesophagus cancer (n = 1) as well as need for long-term central venous access for intravenous therapy (n = 1) with a contraindication to or failed implantation in a standard position owing to central vein occlusions. Technical success was 100 %. A number of five devices were placed in the right, three in the left thigh. Altogether 1,979 catheter days were analysed. One device was explanted owing to infection after 84 days (late complication, 0.05/100 catheter days). No early complication was observed.

CONCLUSIONS: Our data suggest that if implantation of a TIVPP is not favourable in a standard chest, upper arm or forearm position, femoral placement of the device may alternatively be used safely and with high technical success.