Assessment of long-term complications in adult oncology patients with superior vena cava syndrome receiving tunneled femoral inserted central catheters: a prospective cohort study

Superior vena cava syndrome (SVCS) in cancer patients often requires prolonged vascular access. This study evaluates tunneled femoral inserted central catheter (TFICC) outcomes in adult oncology patients with SVCS. A prospective cohort study of 89 SVCS patients receiving TFICCs at Sun Yat-sen Univesity Cancer Center between March and June 2022. Primary outcomes included complication rates, including dislodgement, occlusion, abnormal blood reflux, skin injury, thrombosis, unplanned removal. Logistic regression was performed to identify risk factors for these complications. Among 89 patients, 47.2% (42/89) experienced TFICC-related complications, most commonly dislodgement (23.6%, 21/89), while only 5.6% (5/89) required catheter removal. Protective factors against occlusion included use of Groshong catheters with distal valve (OR=0.098; 95%CI=0.010-0.991; P = .049) and male sex (OR=0.068; 95%CI=0.008-0.584; P =.014). Longer catheter length reduced dislodgement risk (OR=0.685; 95% CI=0.531–0.883; P =.004), while prolonged indwelling duration increased it (OR = 1.009; 95% CI = 1.001–1.017; P =.029). Larger thigh circumference predicted abnormal blood reflux (OR = 1.168; 95% CI:1.008–1.354; P =.039). TFICCs demonstrate low infection and thrombosis rates in SVCS patients. However, high dislodgement rates (23.6%) indicate a need for better securement techniques. Additionally, distal-valve catheters (Groshong) showed advantages over proximal-valve models (Power PICC SOLO), particularly for ambulatory patients, suggesting they may be preferable for reducing occlusion in mobile patients. This study was registered at the Chinese Clinical Trial Registry on 21 February 2022 (registration number: ChiCTR2200055864).