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Clinical impact of peripherally inserted central catheters vs implanted port catheters in patients with cancer: an open-label, randomised, two-centre trial

Taxbro, Knut ; Hammarskjöld, Fredrik ; Thelin, Bo ; Lewin, Freddi ; Hagman, Helga LU ; Hanberger, H. and Berg, Sören (2019) In British Journal of Anaesthesia 122(6). p.734-741
Abstract
Background
Centrally inserted totally implanted vascular access ports (PORTs) and peripherally inserted central catheters (PICCs) are widely used for the administration of chemotherapy. Our aim was to study the incidence of catheter-related deep venous thrombosis in patients with cancer receiving chemotherapy through either a PICC or a PORT.

Methods
Adults with non-haematological cancer (mainly breast and colorectal) from two Swedish oncology centres were included and followed for up to 1 yr. Patients were randomly assigned to receive a single-lumen PICC or PORT. The primary end point was the occurrence of a clinically significant catheter-related deep venous thrombosis, and the secondary end point was a composite of... (More)
Background
Centrally inserted totally implanted vascular access ports (PORTs) and peripherally inserted central catheters (PICCs) are widely used for the administration of chemotherapy. Our aim was to study the incidence of catheter-related deep venous thrombosis in patients with cancer receiving chemotherapy through either a PICC or a PORT.

Methods
Adults with non-haematological cancer (mainly breast and colorectal) from two Swedish oncology centres were included and followed for up to 1 yr. Patients were randomly assigned to receive a single-lumen PICC or PORT. The primary end point was the occurrence of a clinically significant catheter-related deep venous thrombosis, and the secondary end point was a composite of adverse events related to the catheter: insertion complication, thrombosis, occlusion, infection, and mechanical problems.

Results
The trial recruited 399 participants (PICC, n=201; PORT, n=198) between March 2013 and February 2017. The PICCs were associated with 16 (8%) deep venous thromboses compared with two (1%) in the PORT group (HR=10.2; 95% confidence interval, 2.3–44.6; P=0.002). The overall incidence of composite adverse events was higher for patients with a PICC compared with those with a PORT (HR=2.7; 95% confidence interval, 1.6–4.6; P<0.001).

Conclusions
PICCs are associated with higher risk for catheter-related deep venous thrombosis and other adverse events when compared with PORTs. This increased risk should be considered when choosing a vascular access device for chemotherapy, especially in patients with solid malignancy. (Less)
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author
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publishing date
type
Contribution to journal
publication status
published
in
British Journal of Anaesthesia
volume
122
issue
6
pages
734 - 741
publisher
Elsevier
external identifiers
  • scopus:85064326103
ISSN
1471-6771
DOI
10.1016/j.bja.2019.01.038
language
English
LU publication?
no
id
c0efa6d2-b874-4676-bcc0-e96a949e40ed
date added to LUP
2022-09-25 22:58:07
date last changed
2022-09-26 07:30:10
@article{c0efa6d2-b874-4676-bcc0-e96a949e40ed,
  abstract     = {{Background<br/>Centrally inserted totally implanted vascular access ports (PORTs) and peripherally inserted central catheters (PICCs) are widely used for the administration of chemotherapy. Our aim was to study the incidence of catheter-related deep venous thrombosis in patients with cancer receiving chemotherapy through either a PICC or a PORT.<br/><br/>Methods<br/>Adults with non-haematological cancer (mainly breast and colorectal) from two Swedish oncology centres were included and followed for up to 1 yr. Patients were randomly assigned to receive a single-lumen PICC or PORT. The primary end point was the occurrence of a clinically significant catheter-related deep venous thrombosis, and the secondary end point was a composite of adverse events related to the catheter: insertion complication, thrombosis, occlusion, infection, and mechanical problems.<br/><br/>Results<br/>The trial recruited 399 participants (PICC, n=201; PORT, n=198) between March 2013 and February 2017. The PICCs were associated with 16 (8%) deep venous thromboses compared with two (1%) in the PORT group (HR=10.2; 95% confidence interval, 2.3–44.6; P=0.002). The overall incidence of composite adverse events was higher for patients with a PICC compared with those with a PORT (HR=2.7; 95% confidence interval, 1.6–4.6; P&lt;0.001).<br/><br/>Conclusions<br/>PICCs are associated with higher risk for catheter-related deep venous thrombosis and other adverse events when compared with PORTs. This increased risk should be considered when choosing a vascular access device for chemotherapy, especially in patients with solid malignancy.}},
  author       = {{Taxbro, Knut and Hammarskjöld, Fredrik and Thelin, Bo and Lewin, Freddi and Hagman, Helga and Hanberger, H. and Berg, Sören}},
  issn         = {{1471-6771}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{734--741}},
  publisher    = {{Elsevier}},
  series       = {{British Journal of Anaesthesia}},
  title        = {{Clinical impact of peripherally inserted central catheters vs implanted port catheters in patients with cancer: an open-label, randomised, two-centre trial}},
  url          = {{http://dx.doi.org/10.1016/j.bja.2019.01.038}},
  doi          = {{10.1016/j.bja.2019.01.038}},
  volume       = {{122}},
  year         = {{2019}},
}