Evaluation of the amount of residual lipid emulsion in chambers of flushed totally implantable venous access devices using fluorescence imaging

The aim of the present study was to use a quantitative fluorescence imaging technique to evaluate the invisible amount of residual lipid emulsion in port chambers flushed with various fundamental protocols. Chambers were filled with lipid emulsion containing indocyanine green and then flushed with 5–70 mL of normal saline. Chambers were flushed at various speeds (15–60 mL/min), with a time interval of 1 or 3 s between boluses, and with varying directions of flow. The slower the flushing speed, the more lipid emulsion that remained. Pulsatile flushing with either time interval did not decrease the residual amounts, and the areas well-cleansed after flushing were oriented to the bevel-opening direction. These findings suggest that to reduce the residual amount of lipid emulsion poured in a chamber, fast and furious flushing under continuous as opposed to pulsatile flushing is of paramount importance.