# Complications of Port-a-Cath Systems: An Institutional Study on Romanian Oncological Patients

## TL;DR

This study examines the safety and complications of port-a-cath systems in cancer patients at a Romanian hospital, finding that infections and thrombosis are common but manageable without device removal.

## Contribution

The study provides real-world evidence on port-a-cath complications in oncology patients, emphasizing standardized care and management strategies.

## Key findings

- Infections and thrombosis were the most common complications, affecting 10 and 6 patients respectively.
- Most complications did not require device removal and were manageable with standardized care.
- Thrombosis showed a near-significant association with complications (p = 0.051).

## Abstract

The present study assesses complications associated with port-a-cath systems (PCSs) in cancer patients. These devices are essential for drug administration in oncological care settings; however, they pose certain risks, such as infection, thrombosis, and other mechanical issues. By analyzing 124 patients at The Oncology Institute “Prof. Dr. Ion Chiricuță,” Cluj-Napoca, Romania, the authors aimed to determine the incidence of PCS-related complications, their relationship with known prognostic factors, and strategies for management. The findings show that PCSs are largely safe, with infections and thrombosis being the most common complications, most of which can be managed without device removal. Standardized care and early complication management facilitate long-term PCS use, potentially improving patient quality of life. These results provide real-world evidence for healthcare practitioners, encouraging safer PCS use and calling for future studies on complication prevention and management.

Background: Rising cancer incidence and mortality have increased the use of central venous catheters (CVCs), including peripherally inserted central catheters (PICCs) and port-a-cath systems (PCSs), which play an important role in treatment administration. However, CVCs are associated with mechanical, infectious, and thrombotic complications. This study evaluates PCS-related complications and their management in oncological patients at The Oncology Institute “Prof. Dr. Ion Chiricuță,” Cluj-Napoca, Romania. Methods: This non-randomized, observational, retrospective study included cancer patients who had a PCS implanted at The Oncology Institute “Prof. Dr. Ion Chiricuță,” Cluj-Napoca, between 1 January 2024 and 31 December 2024 and were enrolled in a follow-up protocol to monitor and manage PCS-related complications. This study evaluated the incidence of complications, their association with predefined prognostic factors, and their management. Results: In the study cohort (n = 124 patients), complications related to the PCS were observed in 20% of the patients, with a mean interval to complication onset of 47 days. Early-onset complications were observed in 40% of patients, while the remaining 60% developed late-onset complications. PCS infection was the most common complication (10 patients), followed by wound dehiscence and thrombosis (6 patients each). Bleeding, extravasation, catheter migration, port malfunction, and torsion were each documented in a single patient. No prognostic factors were significantly associated with early or late PCS complications, with thrombosis approaching significance (p = 0.051). Conclusions: PCSs are generally safe in oncology patients; infections and thrombosis predominate as PCS-related complications, but rarely require removal, and standardized care enables long-term use, improving patient quality of life.