Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Venous port occlusion can be either partial, when infusion is usually possible but aspiration fails, or complete, when neither infusion nor aspiration can be performed. Persistent Withdrawal Occlusion (PWO) is a special entity, specifically a form of partial occlusion characterized by persistent or intermittent inability to perform aspiration. It is advisable to follow certain precautionary measures to maintain port patency. Venous occlusions can be divided into non-thrombotic and thrombotic occlusions; obliterations caused by the presence of a Fibroblastic Sleeve (FS) constitute a special group. Ignoring the PWO phenomenon entails a higher risk of drug administration outside the Cavoatrial Junction (CAJ), with potential extravasation in extreme cases. Medical staff must make sure that the drug administered into the port enters the blood stream near the CAJ, they should also ideally identify the cause of the PWO. In our original study, we focused on cancer patients with intravenous ports referred to the Cannulation Center of Agel Nový Ji?ín Hospital for PWO resolution. In the majority of cases, PWO was caused by the presence of FS, and after performing Mechanical Disruption (MD) using the rapid flush application to the port with a syringe of saline, venous return was restored in 53.5% of cases. Where this method failed, the patient was indicated for the administration of a plug with urokinase, or low-dose thrombolysis with alteplase (2 mg+50 ml from saline/2 hrs) was performed. After the administration of thrombolytics, the patency of 97.4% of all ports was restored.
Published Date: 2024-09-13; Received Date: 2024-08-14