From the Guidelines
It is not recommended to place a Tunneled Venous Port (TVP) on the same side as a Permcath (Peripherally Inserted Central Catheter, PICC) due to the increased risk of thrombotic complications and other potential issues. Placing multiple catheters in the same venous system can lead to various complications, including thrombosis, stenosis, and infection, as suggested by the guidelines for clinical nutrition in chronic intestinal failure 1. When a Permcath is already in place, it occupies significant space in the vein and may impair blood flow, making additional catheter placement technically challenging and potentially dangerous. The guidelines recommend that the choice of central venous catheter type and location of exit site is made by a multidisciplinary team, along with an experienced specialist as well as the patient 1. Additionally, right-sided access is preferable to a left-sided approach with respect to risk for thrombotic complications, according to the guidelines 1. If vascular access is urgently needed and no other options exist, consultation with interventional radiology or vascular surgery is essential before attempting same-side placement. Alternative access sites should be considered first, such as the contralateral internal jugular vein, femoral veins, or peripheral veins. Key considerations include:
- Maintaining the long-term functionality of the Permcath
- Minimizing the risk of thrombotic complications
- Ensuring easy access and visualization of the catheter exit site for patient self-care
- Avoiding the use of PICCs for long-term HPN due to higher risk of thrombosis and self-administration issues 1. Ultimately, the primary concern is prioritizing the patient's safety and minimizing potential complications, as emphasized by the guidelines for clinical nutrition in chronic intestinal failure 1.
From the Research
Placement of Tunneled Venous Port (TVP) and Permcath (PICC)
- The provided studies do not directly address the question of whether a Tunneled Venous Port (TVP) can be placed on the same side as a Permcath (Peripherally Inserted Central Catheter, PICC) 2, 3, 4, 5, 6.
- However, the studies discuss the complications and utilization of central venous access devices, including TVPs and PICCs, in various patient populations 3, 4, 5, 6.
- One study mentions the placement of permanent jugular catheters, which could be relevant to the placement of TVPs, but does not specifically address the placement of TVPs on the same side as PICCs 6.
- Another study discusses the complications associated with PICC lines, including venous thrombosis, but does not provide information on the placement of TVPs on the same side as PICCs 5.
Complications and Utilization of Central Venous Access Devices
- The studies report various complications associated with central venous access devices, including infection, thrombosis, and catheter malfunction 2, 3, 4, 5, 6.
- The incidence of complications varies depending on the type of device, patient population, and duration of use 3, 4, 5, 6.
- The studies suggest that central venous ports may have lower complication rates compared to PICCs, but may require more hospital visits for management 4.
Relevant Findings
- A study on the utilization and complications of central venous access devices in oncology patients found that PICCs were used more frequently than ports, but had a higher rate of premature removal 4.
- Another study on the comparison of infections and complications in central venous catheters in adults with solid tumors found that central venous ports had lower line infection rates than tunnelled catheters 3.
- A study on venous thrombosis associated with the placement of peripherally inserted central catheters found that the incidence of thrombosis was relatively high, particularly in the cephalic vein 5.