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Mechanical recanalization for clot occlusion of venous access ports: experimental study using ports with clot occlusion

Mechanical recanalization for clot occlusion of venous access ports: experimental study using ports with clot occlusion

J Vasc Access 2017; 18(2): 158 - 162

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/jva.5000677

Authors

Myung Gyu Song, Tae-Seok Seo, Baek-hui Kim, Jeong Ho Kim

Abstract

Purpose

To test the hypothesis that mechanical injection of saline is safe and effective in restoring patency of totally implantable venous access ports (TIVAPs) with clot occlusion. We devised an experimental port model for the evaluation of mechanical TIVAP recanalization prior to its clinical application.

Materials and methods

The clot TIVAP occlusion model was constructed by filling the catheter with swine blood and incubating it at 37.5°C. The model was incubated for different lengths of time ranging from 1 day to 7 days. Each incubation time point included 20 ports. Total catheter occlusion of the TIVAPs was assessed with a 10-mL saline syringe equipped with a non-coring needle. Occlusion was defined as no passage of saline through the catheter when it was aspirated and infused gently with the 10-mL saline syringe. Pressure was evaluated during recanalization with an indeflator. Histological examination was performed on the clot obtained during recanalization.

Results

Among the 140 total experimental ports, 65 occlusions (46.4%) were detected. Of these 65 occlusions, 56 (86.1%) were recanalized by mechanical saline pressure via the indeflator. The indeflator pressure ranged from 29 pound per square-inch (psi) to 265 psi at mechanical catheter recanalization (mean: 110 psi). Histologically, all specimens from the model ports exhibited a similar appearance; specifically, erythrocytes, cells, and fibrin were evenly scattered throughout the clot.

Conclusions

Our data indicate that it is feasible to generate a TIVAP clot occlusion model with swine blood. Moreover, mechanical recanalization was suitable for resolving occluded catheters without thrombolytic agents.

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul - Korea
  • Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Seoul - Korea
  • Department of Radiology, Gachon University Gil Hospital, Gachon University College of Medicine, Incheon - Korea

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