Key result
Apparent catheter migration of central venous port systems was significantly greater in overweight women compared with normal-weight women and men (p<0.001).
Why the study?
Does BMI and sex influence the apparent migration of implantable port devices between supine and upright imaging in patients with central venous access ports?
Observational (n=80)
Does BMI and sex influence the apparent migration of implantable port devices between supine and upright imaging in patients with central venous access ports?
Overweight women exhibit significantly greater apparent migration of central venous port systems between supine and upright imaging compared to other groups, which should be considered during evaluation.
Apparent migration differences warrant caution in overweight women port evaluation; leaves open need for prospective validation of positional effects.
PURPOSE: To evaluate the extent of normal variation in implantable port devices between supine fluoroscopy and upright chest x-ray in relation to body mass index (BMI) based on three different measurement methods. METHODS: Retrospectively, 80 patients with implanted central venous access port systems from 2012-01-01 until 2013-12-31 were analyzed. Three parameters (two quantitative and one semi-quantitative) were determined to assess port positions: projection of port capsule to anterior ribs (PCP) and intercostal spaces, ratio of extra- and intravascular catheter portions (EX/IV), normalized distance of catheter tip to carina (nCTCD). Changes were analyzed for males and females and normal-weight and overweight patients using analysis of variance with Bonferroni-corrected pairwise comparison. RESULTS: PCP revealed significantly greater changes in chest x-rays in overweight women than in the other groups (p<0.001, F-test). EX/IV showed a significantly higher increase in overweight women than normal-weight women and men and overweight men (p<0.001). nCTCD showed a significantly greater increase in overweight women than overweight men (p = 0.0130). There were no significant differences between the other groups. Inter- and intra-observer reproducibility was high (Cronbach alpha of 0.923-1.0) and best for EX/IV. CONCLUSIONS: Central venous port systems show wide normal variations in the projection of catheter tip and port capsule. In overweight women apparent catheter migration is significantly greater compared with normal-weight women and with men. The measurement of EX/IV and PCP are straightforward methods, quick to perform, and show higher reproducibility than measurement of catheter tip-to-carina distance.
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Wyschkon et al. (2015) conducted an observational in Implanted central venous access port systems (n=80). Overweight and female sex vs. Normal-weight women and men was evaluated on Changes in port positions (PCP, EX/IV, nCTCD) between supine fluoroscopy and upright chest x-ray (p=<0.001). Apparent catheter migration of central venous port systems was significantly greater in overweight women compared with normal-weight women and men (p<0.001).
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