Radiologic placement of totally implantable venous access devices: Outcomes and complications from a large oncology cohort.
10.47102/annals-acadmedsg.2024166
- Author:
Sonam TASHI
1
;
Alfred Bingchao TAN
1
;
Jasmine Ming Er CHUA
1
;
Gek Hsiang LIM
2
;
Nanda VENKATANARASIMHA
1
;
Sivanathan CHANDRAMOHAN
1
Author Information
1. Vascular and Interventional Radiology, Singapore General Hospital, Singapore.
2. Health Services Research Unit, Singapore General Hospital, Singapore.
- Publication Type:Journal Article
- Keywords:
TIVAD;
complications;
long-term venous access;
oncology;
ports;
totally implantable venous access device
- MeSH:
Humans;
Middle Aged;
Male;
Female;
Retrospective Studies;
Singapore/epidemiology*;
Aged;
Catheterization, Central Venous/instrumentation*;
Neoplasms/drug therapy*;
Catheters, Indwelling/adverse effects*;
Adult;
Jugular Veins/diagnostic imaging*;
Aged, 80 and over;
Catheter-Related Infections/epidemiology*;
Central Venous Catheters/adverse effects*
- From:Annals of the Academy of Medicine, Singapore
2024;54(1):27-35
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Totally implantable venous access devices (TIVADs) or ports are increasingly used in oncology settings to provide long-term, easy venous access. This study reports our experience and results with 1180 cases in Singapore.
METHOD:Data from January 2019 to January 2022, obtained from a hospital-approved secure database application called the Research Electronic Data Capture registry, were reviewed and analysed retrospectively.
RESULTS:A total of 1180 patients underwent TIVAD implantation with a 100% technical success rate. The mean age of the cohort was 61.9 years. The mean dwell duration was 342 days (standard deviation [SD] 223; range 3-1911). By 1 February 2022, 83% of patients were still using the TIVAD, 13.6 % underwent removal after completion of treatment, 2.1% were removed due to infection, 0.6% due to malfunction, 0.6% due to port extrusion and 0.1% at patient's request. The right internal jugular vein (IJV) was the most commonly accessed site (83.6%), followed by the left IJV (15.6%). The early post-procedure complications were pain (24.7%), bruising (9.2%), swelling (3.6%), bleeding (0.5%), fever (0.4%), itchiness (0.2%) and allergic dermatitis (0.1%). The delayed post-procedure complications were TIVAD site cellulitis (3.80%); discharge (1.10%); skin erosion with device extrusion (0.60%); malpositioned catheter (0.33%), which was successfully repositioned, catheter-related bloodstream infections (0.25%); migration of TIVAD leading to catheter dislodgement (0.25%); venous thrombosis (0.25%); fibrin sheath formation requiring stripping (0.10%) and TIVAD chamber inversion (0.10%).
CONCLUSION:TIVAD implantation via the jugular vein under radiological guidance provides a safe, reliable and convenient means of long-term venous access in oncology patients. By sharing our experience and acceptable outcomes from a large oncology cohort, we aim to increase the awareness and adoption of TIVAD usage in oncology patients, especially in Asia.
