Port catheter thickness and its correlation with complications - exploring the millimeter threshold

Port catheters are indispensable in modern oncologic and medical care. Despite their benefits, complications such as skin erosion and related mechanical issues remain a significant concern. While numerous studies have explored prevention and management strategies, the influence of port reservoir thickness on these complications has not been systematically evaluated. This study investigates whether port thickness independently contributes to skin erosion risk, aiming to inform device selection and placement strategies. This retrospective single-center study included 662 patients who underwent port catheter implantation at Istanbul Başakşehir Çam ve Sakura City Hospital between June 2022 and October 2024. Data on demographics, port brand, reservoir height, and revision status were analyzed. Appropriate nonparametric tests were used for group comparisons, and Spearman correlation and multivariate logistic regression were performed to assess the association between reservoir height and revision risk. A p-value < 0.05 was considered statistically significant. Among 662 patients, 29 experienced skin erosion requiring revision, corresponding to a 4.4% overall revision rate. All revisions were due to skin erosion; no major or infectious complications occurred. Reservoir heights of the four port brands, 10.6 mm (n = 257), 11.6 mm (n = 58), 12.2 mm (n = 219), and 13.2 mm (n = 128), demonstrated a trend toward higher revision rates with increasing port thickness. Spearman correlation analysis demonstrated a weak but significant positive relationship between reservoir height and revision risk (r = 0.168, p < 0.001), indicating a size-dependent trend. In multivariate logistic regression, both port reservoir height and anti-VEGF therapy emerged as independent predictors of revision. Compared with 10.6-mm ports, 12.2-mm and 13.2-mm ports were associated with 4.47- and 10.39-fold higher revision risks (p = 0.023 and p < 0.001, respectively). Anti-VEGF therapy increased the revision risk by approximately 2.9-fold (p = 0.022). Port reservoir thickness is an independent predictor of skin erosion requiring revision. Thicker ports were linked to higher complication rates, particularly in patients receiving anti-VEGF therapy, underscoring the importance of device selection and design considerations in clinical practice. These findings suggest that thinner-profile ports should be preferred when feasible. Prospective studies are needed to validate these findings and establish evidence-based recommendations for port selection and placement.