Complications following implantable venous access port placement: Surgery versus interventional radiology.

Abstract

522 Background: Implantable venous access ports are commonly placed by surgeons and interventional radiologists (IR) for delivery of systemic cancer therapy and other long-term intravenous therapies. Existing studies report similar complication rates between specialties but often do not account for differences in patient complexity, socioeconomic vulnerability, and access to care. In safety-net health systems, where resource constraints are critical considerations, understanding whether outcomes are driven by procedural specialty or patient-level factors may inform more efficient care delivery. Our study evaluated predictors of port-related complications and compared outcomes between surgery- and IR-placed ports at a single academic safety-net center. Methods: We retrospectively reviewed adults undergoing port placement by surgery or IR from January 2024–December 2025 (N=146). Demographics, comorbidities, cancer characteristics, and outcomes were collected. The primary outcome was port-related complications, including infection, thrombosis, malposition, malfunction, pneumothorax, arrhythmia, and failed placement. Univariate analyses were performed using Fisher’s exact and Mann-Whitney U tests. Multivariable logistic regression identified factors independently associated with complications. Results: Our cohort included 109 surgery and 37 IR patients. Compared with surgery patients, IR patients were younger, more frequently anticoagulated, underinsured, had metastatic disease, and had prior thromboembolic disease. Despite these baseline differences, complication rates were comparable between IR and surgery patients (13.5% vs 20.2%, p=0.467). Complications occurred in 27 patients and included thrombosis (n=8), malfunction (n=7), infection (n=5), malposition (n=3), failed placement (n=3), and pneumothorax (n=2). Female sex was associated with complications and remained significant after adjustment (aOR 3.25, 95% CI 1.28-9.10). Port-placing specialty was not independently associated with complications (aOR 0.60, 95% CI 0.16-1.92). Conclusions: Despite greater patient complexity among patients undergoing IR-placed ports, complication rates were comparable between specialties. After adjustment, provider specialty was not associated with complications, whereas female sex remained an independent predictor, suggesting that patient-level factors may play a larger role in port-related outcomes than procedural specialty. Patient characteristics and outcomes by port placement service. Variable Surgery (n=109) IR (n=37) p-value Complication Rate (%) 20.2 13.5 0.467 Age, median (IQR) 62 (18.5) 54 (16) 0.002 Female Sex (%) 54.1 43.2 0.261 Frailty Index ≥2 (%) 29.4 27.0 0.829 Metastatic Disease (%) 49.5 70.3 0.036 Under/Uninsured (%) 11.9 37.8 0.001 Anticoagulated (%) 18.4 43.2 0.004 Hx of Thromboembolic Events (%) 13.8 29.7 0.044