MedComp DIGNITY Instructions D'utilisation page 6

IMPLANTATION INSTRUCTIONS:
• Please read through complete implantation instructions before
implanting port, noting "Contraindications, Warnings, and
Precautions" and "Possible Complications" sections of this manual
before beginning procedure.
PREVENTING PINCH-OFF
• The risk of pinch-off syndrome can be avoided by inserting the
catheter via the internal jugular vein (IJ). Subclavian insertion of
the catheter medial to the border of the first rib may cause catheter
pinch-off, which in turn results in occlusion causing port system
failure during power injection.
• If you choose to insert the catheter into the subclavian vein,
it should be inserted lateral to the border of the first rib or at
the junction with the axillary vein because such insertion will
avoid compression of the catheter, which can cause damage and
even severance of the catheter. The use of image guidance upon
insertion is strongly recommended. A radiographic confirmation
of catheter insertion should be made to ensure that the catheter is
not being pinched.
IMPLANTATION PREPARATION
1. Select implantation procedure to be used. Note: Recommended
veins for arm placement are cephalic, basilic, or medial cubital
basilic. Note: Recommended veins for chest placement are internal
jugular or lateral subclavian. Refer to "Warning" section covering
catheter pinch-off if inserting the catheter via subclavian vein.
2. Select the site for port placement. Note: Port pocket site selection
should allow for port placement in an anatomic area that provides
good port stability, does not interfere with patient mobility, does
not create pressure points, has not previously been irradiated, does
not show signs of infection, and does not interfere with clothing.
For arm port placement, site should be distal to the desired vein
insertion site. Consider the amount of cutaneous tissue over
the port septum, as excessive tissue will make access difficult.
Conversely, too thin a tissue layer over the port may lead to tissue
erosion. A tissue thickness of 0.5cm to 2cm is appropriate.
3. Complete patient implant record, including product reorder number
and lot number.
4. Perform adequate anesthesia.
5. Create sterile field and open tray.
6. Surgically prep and drape the implantation site.
7. For Attachable Catheters: Flush open-ended catheters with
heparinized saline and clamp the catheter closed several
centimeters from the proximal (port) end. Remember that some
patients may be hypersensitive to heparin or suffer from heparin
induced thrombocytopenia (HIT) and these patients must not have
their port primed with heparinized saline. Note: Clamp catheter
segments that will be cut off prior to attachment.
CUT-DOWN PROCEDURE
1. Place patient in the Trendelenburg position with head turned away
from the intended venipuncture site. For arm port placement,
position the arm in an abducted, externally rotated position. Use a
cut-down incision to expose the entry vein of choice.
2. Perform vessel incision after vessel is isolated and stabilized to
prevent bleeding and air aspiration.
3. If using a vein pick, insert its tapered end through the incision
and advance it into the vessel. Then slide the catheter tip into the
grooved underside of the pick.
CATHETER
VESSEL
VEIN PICK
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