Authors: Togola Birama, Bengaly Bréhima, Touré Cheick Ahmed Sekou, Ouattara Drissa, Ly Madani, Coulibaly Bréhima, Coulibaly Mahamadou, Traoré Drissa, Sanogo Souleymane, S Diallo Siaka, Ongoïba Nouhoun.
Purpose: The aim of this study was to evaluate indications, feasibility and complications of percutaneous approach for positioning implantable venous access system in the department of surgery “B”.
Materials and Methods: The files of all patients who have profited from an implantable catheter chamber for 3 years from 2013 to 2016 were re-examined and analyzed retrospectively. A clinical exam and a preoperative evaluation were systematically performed.
Results: During this period 45 patients profited for positioning implantable venous access system. They were 23 women and 22 men for mean age of 53.0 ± 16.2 years. The implantation was performed specially by percutaneous approach or surgical approach in failure. The main indications were for chemotherapy in cancer for 39 (86.7%) patients, a parenteral nutrition and central venous access for perfusion respectively for 3 (6.6%) patients. We used primarily percutaneous approach by puncture of the internal jugular vein for 39 cases (86.7%) and a surgical cephalic dissection for 6 patients (13.3%). All procedures were performed on right. The operational incidents were related to the difficulty of puncture for 7 patients (15.5%), of progression of the wire for 6 (13.3%) and carotid arterial puncture for 1 (2.2%) patients. We observed one case of failure of implantation. A chest X-ray was systematic after device installation. The evolution was favorable for all patients. For the medium and longterm outcomes, we observed 4 cases (8.8%) of infection including 2 local infection and 2 malignant hyperthermia considered as a septicemia. All procedures were performed in operating room and outpatient.
Conclusion: Implantable venous access system is important for management of oncology patients. The percutaneous approach is an alternative as elegant, fast and safe as the surgical access.
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