Once Weekly Subcutaneous Ports for the Administration of Anticoagulants

Subcutaneous ports have recently been used to administer Low Molecular Weight Heparin (LMWH) to patients for the prevention or treatment of venous thromboembolism; however, no studies have been performed to evaluate the ports' reliability in delivering this type of drug. Hence, it is not known whether absorption of the drug is constant over the seven-day lifespan of the port. Although the use of subcutaneous ports is not currently the standard of care, health care providers are more frequently using this as an alternative method to direct injection of LMWH, particularly in pediatric patients.

The main advantage of subcutaneous ports is the decreased number of needle sticks when using the ports to administer the medication. However, it is possible that, due to potential repeated bleeding into the subcutaneous space at the port site or other factors, drug absorption may decrease over the seven day lifespan of the port, resulting in a decrease of plasma drug level. Subtherapeutic LMWH levels and, hence, ineffective anticoagulation may result. This study's aim is to determine if the current use of subcutaneous ports is a safe, effective and reliable way of administering LMWH for the purpose of anticoagulation.

Inclusion criteria

• Subjects receiving once or twice daily dosing of therapeutic doses of subcutaneous Enoxaparin.
• Subject has been on the same dose of Enoxaparin for at least one week.
• Anticipated length of Enoxaparin treatment at least 4 weeks.
• Age ≥ 18 years.
• Subject demonstration of proper subcutaneous catheter care during one education session with the investigator.

Exclusion criteria

• Chronic renal insufficiency with glomerular filtration rate < 30 mL/min.
• Pregnancy
• Venous thromboembolism within the last 4 weeks.