Implantable catheter chambers: a 14-year descriptive study

IntroductionImplantable catheter chambers are widely used devices during the treatment of cancer whether for taking blood samples or for chemotherapy infusion. The placement of this type of chamber has significantly improved the care of cancer patients. However, it can expose the patients to numerous complications which may be related to the device itself or the implantation technique.AimThe aim of this single-center study was to determine the epidemiological profile of patients who had undergone this procedure, identify the main indications for implantation, and most importantly to compare the techniques used for implantation.MethodsWe conducted a retrospective descriptive study at the surgical intensive care unit of Ibn Rochd University Hospital in Casablanca from January 2009 to December 31, 2022, including 3197 patients who had an implantable catheter chamber placed. Data were collected prospectively.ResultsThe average age of the 3197 patients was 51 years; 63.60% of them had breast cancer. The most dominant age group was patients between 40 and 60 years. The main indication for the implantable chamber was chemotherapy for breast cancer at a rate of 63.60%, followed by gastrointestinal cancer at 15.09%. It is noted that 81.26% of the patients had a right-side approach and the most punctured vein was the right internal jugular vein (IJV) with a rate of 70.49%, followed by the left IJV at 28.37%. The percutaneous approach was the only method used. Percutaneous puncture of the right IJV was the preferred technique due to anatomical landmarks and accessibility of the vein. Ultrasound guidance during the puncture of the vein in question was used in 87% of patients. The average duration of the procedure was between 10 and 15 min. No per operative complications (arterial puncture, hematoma, pneumothorax) were observed. Prophylactic antibiotic therapy was administered to all patients.ConclusionThe placement of the chamber by ultrasound-guided percutaneous access to the IJV is a minimally invasive and safe technique that complies with the specifications of the 2008 Standards, Options and Recommendations (SOR) recommendations. Less invasive than surgical access and safer than "blind" puncture, it constitutes a reliable, simple procedure that minimizes subsequent risks to the greatest extent possible.