Document Detail

Wound healing and catheter thrombosis after implantable venous access device placement in 266 breast cancers treated with bevacizumab therapy.
MedLine Citation:
PMID:  21970853     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to determine, in a population with metastatic breast cancer treated with bevacizumab therapy, the incidence of wound dehiscence after placement of an implantable venous access device (VAD) and to study the risk of catheter thrombosis. This study enrolled all VADs placed by 14 anesthetists between 1 January 2007 and 31 December 2009: 273 VADs in patients treated with bevacizumab therapy and 4196 VADs in patients not treated with bevacizumab therapy. In the bevacizumab therapy group, 13 cases of wound dehiscence occurred in 12 patients requiring removal of the VAD (4.76%). All cases of dehiscence occurred when bevacizumab therapy was initiated less than 7 days after VAD placement. Bevacizumab therapy was initiated less than 7 days after VAD placement in 150 cases (13 of 150: 8.6%). The risk of dehiscence was the same from 0 to 7 days. In parallel, the VAD wound dehiscence rate in patients not receiving bevacizumab therapy was eight of 4197 cases (0.19%) (Fisher's test significant, P<0.001). No risk factors of dehiscence were identified: anesthetists, learning curves, and irradiated patients. VAD thrombosis occurred in four patients (1.5%). In parallel, VAD thrombosis occurred in 51 of 4197 patients (1.2%) not receiving bevacizumab therapy (Fisher's test not significant; P=0.43). Bevacizumab therapy was permanently discontinued in five patients related to wound dehiscence and in one patient due to extensive skin necrosis. These data suggest the need to observe an interval of at least 7 days between VAD placement and initiation of bevacizumab therapy to avoid the risk of a wound dehiscence requiring chest wall port explant. The risk of VAD thrombosis does not require any particular primary prevention.
Irène Kriegel; Paul H Cottu; Virginie Fourchotte; Sebastian Sanchez; Isabelle Fromantin; Krassen Kirov; Alain Guillaume; Anne Pelloquin; Marc Esteve; Remy J Salmon
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anti-cancer drugs     Volume:  22     ISSN:  1473-5741     ISO Abbreviation:  Anticancer Drugs     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-05     Completed Date:  2012-04-02     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9100823     Medline TA:  Anticancer Drugs     Country:  England    
Other Details:
Languages:  eng     Pagination:  1020-3     Citation Subset:  IM    
Department of Anesthésiology, Institut Curie, Paris, France.
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MeSH Terms
Antibodies, Monoclonal, Humanized / therapeutic use*
Breast Neoplasms / drug therapy*,  pathology
Catheterization, Central Venous / adverse effects*,  instrumentation
Catheters / adverse effects
Surgical Wound Dehiscence / epidemiology*,  etiology
Thrombosis / etiology*
Wound Healing*
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V/bevacizumab

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