Anthracycline-induced extravasation

Anthracycline-induced extravasation is a serious complication that can occur after infusion of anthracyclines. In this condition, infusion fluid does not enter the vein but the surrounding tissue.

The reason may be increased vascular permeability in elderly patients or improper puncture or dislocation of the infusion needle.

Anthracyclines are antibiotic compounds used in chemotherapy. They are highly cytotoxic and cause rapid cell death on contact with tissue. As a result of extravasation, swelling, pain, flushing and blistering of the puncture site occur, the rate of infusion decreases. Anthracyclines may remain in the tissue for months and cause damage to ulceration and ultimately necrosis of the tissue. The damaged area has a high susceptibility to infection, it can lead to the formation of scar tissue or the need for an amputation. As a result of extravasation, fever and leukocytosis may occur. The incidence is low; of all the patients receiving anthracycline-induced extravasation, only 25-50% experience severe ulcer.

Prevention plays an important role, so infusion should be via a port rather than a peripheral venous catheter, the correct position of which should be re-radiographically checked before infusion.