Totally Implantable Venous Access Devices Implanted Surgically

Abstract

Background:The techniques used for the implantation of totally implantable venous access devices (TIVADs) are the percutaneous approach and surgical cutdown; however, the choice is still controversial.Hypothesis: The surgical cutdown approach may be beneficial to reduce the rate of complications.Design: Retrospective review.Setting: A university hospital and a tertiary referral center.

Modification of approach for totally implantable venous access device decreases rate of complications

“…Palpation of the catheter on the neck region can be disturbing in some patients. Contrary to venous percutaneous approach, many studies analyzing the venous cutdown approach have shown an absence of immediate perioperative complications [27][28][29][30][31], and for this reason, it should be considered a more valid and safer approach for TIVAD placement [30,31].…”

Outcome of cephalic vein cut-down approach: A safe and feasible approach for totally implantable venous access device placement

“…Venous access via the cephalic vein cut-down (CVCD) method has been widely described as a safe and rapid approach (7)(8)(9)(10). However, this technique is not currently widely used for the placement of TIVADs.…”

Trigger arrhythmia to confirm the position of totally implantable access ports (TIAP)

“…The cutdown method has the advantage of direct vision of cephalic vein and thus have no risks of pneumothorax, hemothorax, and injury of great vessels [3,4]. But the technique needs to be under the fluoroscopic guidance to confirm the position of catheter.…”