Complications of totally implantable venous access devices: experience with 852 Moroccan cancer patients

Abstract

Background: Totally implantable venous access devices (TIVADs) provide easy vascular access in cancer patients for chemotherapy administration, blood products, parenteral nutrition and blood sampling. However, they are associated with several complications which can be divided into early and late. The aim of the present study was to evaluate the various complications related to TIVADs in a single center in Morocco.Methods: This was a retrospective, observational, descriptive study conducted at the Medical Oncology Department of the Military Hospital Moulay Ismail in Meknes, Morocco, during a 6-year period, between January 1st, 2011 and December 31st, 2016. Author included all patients older than or equal to 18 years, with solid malignancies who had TIVAD placement for chemotherapy.Results: A total 852 TIVADs were placed. There were 92 complications (10.8% of patients). Early complications included 16 (1.9%) cases of pneumothorax and 12 (1.4%) cases of arterial puncture with a cervical hematoma. Infection was the most common late complications (2.8%), followed by thrombosis (1.8), extravasations of cytotoxic drugs (1.3%), mechanical dysfunction of the catheter (1.3%) and skin necrosis (0.3%).Conclusions: The results of the analysis confirm the safety and tolerability of TIVADs for chemotherapy administration in Moroccan patients, with similar rates of early and late complications compared to the published data.

Complications and management strategies of totally implantable venous access port insertion through percutaneous subclavian vein

“…[1][2][3] Previous studies regarding the TIVAD insertion are summarized in Table 4. According to the existing Guth [5] Yildizeli et al [6] Araújo et al [7] Narducci et al [8] Keum et al [9] Seok et al [10] Nagasawa et al [11] Aziret et al [12] An et al [13] Gurkan et al [14] Ma et al [15] Zerati et al [16] Feo et al [17] Bazine et al [18] Yanık et al [19] 2018 3000 SV, IJV Kim et al [20] literature, the overall complication rate following TIVAD insertion ranges from 3.1 to 33.9%. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The overall complication rate in our study population was 12.5%, consistent with the results reported in previous studies.…”

“…Although the device removal is not mandatory for all cases with venous thrombosis, the device should be removed if it is non-functional or not necessary. [3,18] Wound problems such as wound dehiscence, skin decubitus, and necrosis may develop following the TIVAD insertion due to the technical failure or patient-related causes. During the device implantation, the creation of subcutaneous pocket close to skin or the selection of inappropriate reservoir size for weak patients can lead to wound healing problems.…”