Complications of in-dwelling venous access devices: A single institution experience

Objective: To determine the complications of venous access devices (VADs) in cancer patients. Setting: Retrospective study in a tertiary referral center with specialist hematology and oncology services. Subjects: First one hundred consecutive patients who were implanted a VAD. All patients had an underlying cancer and the devices were inserted by the same surgeon. The duration of use of VADs and causes of their premature removal were noted. Results: One hundred VADs (55 port-a-caths and 45 Hickman's lines) were inserted in a total of 89 patients over a 7.5 year period. Majority of patients had acute myeloid leukemia (22) gastrointestinal malignancies (20) breast cancer (19) and genito-urinary cancers (15). The mean duration of use was 110 days; 157 days for the port-a-cath and 53 days for the Hickman's line. Nineteen devices (10 port-a-caths and 9 Hickman's lines) had to be removed prematurely. Two Hickman's lines got removed accidentally. The causes of premature removal included device failure (9), exit site infection (4), luminal infection (3) and tunnel infection (3). Conclusion: The mean duration of use and the complication rates are comparable with studies reported in the literature.