Availability of totally implantable venous access devices in cancer patients is high in the long term: a seven-year follow-up study

Latif Volkan Tumay,Osman Serhat Guner

doi:10.1007/s00520-020-05871-6

Abstract

PurposeTotally implantable venous access devices (TIVADs) currently have an important place in medical oncology practice; however, their long-term availability deserves further investigation, since they are usually required by patients for prolonged periods. This study aimed to evaluate long-term availability of TIVADs in adult cancer patients, in conjunction with complication/removal rates over time and associated risk factors during 7-year follow-up.MethodsA total of 204 adult cancer patients who underwent TIVAD placement via subclavian vein using the Seldinger technique were included in this study. Medical data and catheter follow-up records were investigated retrospectively. Complications and port removals due to complications were evaluated over time.ResultsDuring median 21.9 (range, 0.7–82.9) months of follow-up, great majority of the patients did not require catheter removal due to complications (91.7%). During a total follow-up of 183,328 catheter days, 20 (9.8%) patients had complications with an incidence of 0.109 cases per 1000 catheter days and 18 (8.8%) of them required TIVAD removal (0.098 cases per 1000 catheter days). Most device removals due to complications (15/18, 83.3%) occurred within the first 24 months. Multivariate analysis identified left-sided device location as the only significant independent predictor of short device availability (OR, 3.5 [95% CI, 1.1–11.1], p = 0.036).ConclusionTIVADs in cancer patients appear to be safe and their availability appears to be high in the long term. A decision for early removal might be revisited. Opting for the accustomed side (right side in the present study) for implantations seems to be associated with better outcomes.

Highlights

We aimed to evaluate long-term availability of totally implantable venous access devices (TIVADs) in adult cancer patients, in conjunction with complication/removal rates over time and their associated risk factors during a 7-year follow up-period
Data on patient demographics, indication for TIVAD, body mass index (BMI; kg/m2), operative time, complications, catheter insertion site, duration of catheter in situ, and reasons for port removal were retrieved for each patient
Almost two-thirds of the TIVADs were implanted for gastrointestinal malignancies (63.7%), followed by breast cancer (22.1%)

Summary

Introduction

Niederhuber et al [3] introduced the first implantable port system in 1982, after which totally implantable venous access devices (TIVADs) have become an inseparable part of the medical oncology practice, replacing the external catheters owing to their ability to improve patients’ quality of life and excellent compliance rates [4]. These devices can be inserted into the subclavian vein or internal jugular vein through open surgery, Seldinger technique, or under ultrasound guidance [4,5,6].

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