Email updates

Keep up to date with the latest news and content from BMC Surgery and BioMed Central.

Open Access Research article

Totally implantable venous access devices: retrospective analysis of different insertion techniques and predictors of complications in 796 devices implanted in a single institution

Elisa Granziera1, Marco Scarpa2*, Angelo Ciccarese1, Bogdan Filip3, Matteo Cagol2, Valentina Manfredi1, Rita Alfieri2, Connie Celentano1, Sandra Cappellato1, Carlo Castoro2 and Muzio Meroni1

Author Affiliations

1 Anestesiology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy

2 Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy

3 Department of Surgery, Iasi University Hospital, Iasi, Romania

For all author emails, please log on.

BMC Surgery 2014, 14:27  doi:10.1186/1471-2482-14-27

Published: 8 May 2014

Abstract

Background

The aim of this study was to assess the efficacy and safety of totally implanted vascular devices (TIVAD) using different techniques of insertion.

Methods

We performed a retrospective study using a prospective collected database of 796 consecutive oncological patients in which TIVADs were inserted. We focused on early and late complications following different insertion techniques (surgical cutdown, blind and ultrasound guided percutaneous) according to different techniques.

Results

Ultrasound guided technique was used in 646 cases, cephalic vein cutdown in 102 patients and percutaneous blind technique in 48 patients. The overall complication rate on insertion was 7.2% (57 of 796 cases). Early complications were less frequent using the ultrasound guided technique: arterial puncture (p = 0.009), technical failure (p = 0.009), access site change after first attempt (p = 0.002); pneumothorax occurred in 4 cases, all using the blind percutaneus technique. Late complications occurred in 49 cases (6.1%) which required TIVAD removal in 43 cases and included: sepsis (29 cases), thrombosis (3 cases), dislocation (7 cases), skin dehiscence (3 cases), and severe pain (1 case).

Conclusion

Ultrasound guided technique is the safest option for TIVAD insertion, with the lowest rates of immediate complications.

Keywords:
Totally implantable venous access device; US guided; Chemotherapy