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Use of totally implantable venous access devices for administration of chemotherapy has found increasing usage even in developing countries like India. Sometimes, it is an essential component of therapy. This device, commonly referred to as chemoport is usually placed over the chest wall below the clavicle or sometimes in the arm [1]. Commonly eith...
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Although the cephalic vein follows a fairly consistent course, numerous variants have been reported. We found a rare anatomical presentation of the cephalic vein in a 75-year-old Korean male cadaver. The left cephalic vein was identified in the deltopectoral groove, ascended over the clavicle, and terminated into the left subclavian vein just befor...
Citations
... Modern anticoagulants development and surgical technique improvement allows to decrease VTE (and other complications) risks. For example in 2011 Harish and Madhu has reported 2 femoral implantation cases with 12 months follow-up without any thrombotic complications [9]. In 2015 2 years retrospective analysis with 5 uncomplicated was published [10]. ...
... First, carheter directed through CFV into inferior caval vein under angiography navigation (Figure 2), After tip positioning, on the hip front side, the port capsule implanted subcutaniously and connected with catheter ( Figure 4). Capsule implantation area is a controversial question -the most of colleagues supports abdominal wall or iliac bone placement [9,10]. In our point, hip front side is more comfortable and physiological for patient. ...
Learning objectives To discuss the indications and technical features for port-system implantation in oncology patients with caval occlusion
... In general, chemo port is placed over the chest wall after the access through the subclavian or IJV. [1] Femoral approach is indicated when massive cutaneous metastases or severe radiodermatitis in the upper part of the torso is present where one cannot place the port. [2] In our case, it was due to SVC thrombosis which is a very rare indication itself. ...
... Dholaria SG, Yadav D 1 , Gupta AK 1 ...
... Так, в 2011 г. K. Harish и Y. Madhu сообщили о двух случаях бедренной имплантации порт-систем с продолжительностью послеоперационного наблюдения 12 мес без какихлибо тромботических осложнений [9]. В 2015 г. был представлен ретроспективный анализ пяти случаев чрезбедренной имплантации с длительностью наблюдения до двух лет без каких-либо осложнений [10]. ...
... Еще одним дискуссионным моментом является место имплантации капсулы порт-системы. Ряд авторов предлагают размещать ее на передней брюшной стенке или на гребне подвздошной кости [9,10]. На наш взгляд, имплантация на переднюю или боковую поверхность бедра более комфортна для пациента, поскольку область живота может подвергаться постоянным мелким травматизирующим воздействиям от пояса одежды, что снижает качество жизни и общую удовлетворенность лечением. ...
The safe time of peripheral venous catheter usage is 48 hours, for central catheter - up to 14 days. But in clinical oncology for long-term chemotherapy we need to have the long-time functioning venous access. Totally implanted port-system provides this opportunity. Usually device is implanted by subclavian access and this procedure is not very complicated. But in case of superior caval system occlusions it may be a real problem to find an alternative access for catheter guidance to right auricle. In this report authors have described a successful case with femoral port-system implantation in patient with bilateral subclavian veins occlusion. Surgery was performed in hybrid operating room with several imaging technologies - ultrasound scanning, angiography and multispiral computer tomography. In general, femoral port-system implatation is not a routine method characterized by strong restricted indications. The main risk is the venous thromboembolism (VTE) due to for long time (6-12-18 months) the foreign thrombogenic device is persist in inferior caval vein. By the way, anticoagulant prophylaxis, regular ultrasound screening and strong patients and medical staff education for device care allows to reduce VTE risk and to support adequate specific oncology treatment.
Background . In the superior vena cava syndrome, vein catheterisation provides an alternative for vascular access. Few reports describe the usage of femoral ports.
Aim. Description of pros and contras for femoral port installation in patients with haematological malignancies and the superior vena cava syndrome.
Materials and methods . This prospective non-randomised, single-centre study included 163 haematological patients implanted 72 ports in superior vena cava, 35 — in inferior vena cava and inserted with 156 non-tunnelled femoral catheters. Catheterisation properties, complications, duration of use and reasons for port and catheter removal were registered.
Results . No significant differences were observed between ports in superior and inferior vena cava as per the frequency of urokinase use in catheter dysfunction, catheter dislocation, catheter-associated bloodstream and pocket infections. Differences were revealed in the catheter-associated thrombosis rate, which was higher with femoral access (17.0 % or 0.9/1000 catheter days vs. 8.3 % or 0.2/1000 catheter days, p = 0.017). Ports in inferior vena cava had a lesser duration of use than in superior vena cava ( p = 0.0001). Unlike femoral ports, non-tunnelled femoral catheters had higher rates of catheter-associated thrombosis (9/1000 vs. 0.9/1000 catheter days, p = 0.002) and infection (4.9/1000 vs. 0.3/1000 catheter days, p = 0.002). One lymphoma therapy course required one femoral port or 1 to 14 (median 3) non-tunnelled femoral catheters.
Conclusion . Femoral port implantation is a necessary measure in patients with the superior vena cava syndrome. It has advantages in terms of catheterisation frequency, lower infectious and thrombotic complication rates compared to non-tunnelled femoral catheters.
Objectives:
Composite tumors are defined as tumors in which there are two different intermixed histologic types. Our objective was to study the clinical and pathologic features of five cases of composite lymphoma.
Materials and methods:
Our study included five patients of composite lymphoma diagnosed over a period of 5 years. Clinical presentation, hematological parameters including peripheral smear, bone marrow aspirate, and histopathological examination of lymph node including immunohistochemistry (IHC) were studied. Treatment and follow-up details were also noted.
Results:
All the five cases were in the adult age group ranging from 44 to 72 years. All the cases were composite follicular lymphoma (FL) and mixed cellularity classical Hodgkin lymphoma (CHL). Diagnosis in all cases was suspected on morphology by identification of distinct neoplastic follicles in FL and classic Reed-Sternberg cells in CHL and confirmed by IHC.
Conclusion:
Although rare, composite lymphomas should be kept in mind. Careful histopathological examination of lymph node with identification of distinct morphological features along with IHC helps to arrive at the definitive diagnosis.
