A one year prospective evaluation of implantable vascular access devices(IVAD).


B.A. Jolley*, M. Laplume, J. Brunton, and J. Conly

The Toronto Hospital, Toronto, Ontario, Canada

Due to a perceived fluid leakage with IVAD's, a one year prospective evaluation of 81 IVAD's was done. All catheters were assessed for 1 year from insertion date for early(<4 weeks and late (>4 weeks) infection, and early and late thrombosis. Sites were accessed with either a Gripper or Hueber needle and dressed with betadine and op-site. Two catheters were removed due to improper surgical placement. There were no proven new device failures due to leakage. Placement by patient diagnosis was as follows: HIV(61); anaemia(5): thalassaemia(3); venous ac cess difficulty(2); cancer(9); aspergilloma(1). The mean (±SD) age of the cohort was 40.6 ±11.3 years and the majority (95%) were male. There were 18/61(30%) episodes of infection (localized and systemic) in the HIV group but only 3/20(15%) in the non-HIV group, including 10 bacteraemia in the HIV group vs 0.7 in the non-HIV group. Thrombosis (venographic or sonographic diagnosis occurred in 6 individuals (5 HIV; 1 anaemia of the 17 organisms isolated, 14 were staphylococci (6 Staphylococcus aureus; 8 Coagulase negative staphylococci). All patients with confirmed S. aureus (3 site, 5 blood) required removal despite antibiotic therapy. HIV patients with late infection accessed their catheters at least once/day, 5 days/week with a mean (±SD) duration of 124 ±80.5 catheter days. The incidence of bacteraemia (1.4/1000 catheter days) was higher in the population with HIV infection than in the population without (0.02/1000 catheter days) which may reflect the frequent percutaneous access to these devices in the former group.

Back to Posters and Abstracts