Increased Use of Percutaneous Technique for Totally Implantable Venous Access Devices. Is It Real Progress? A 27-Year Comprehensive Review on Early Complications
- 5 March 2010
- journal article
- review article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 17 (6), 1649-1656
- https://doi.org/10.1245/s10434-010-1005-4
Abstract
Background First implantation of a totally implantable venous access device (TIVAD) was performed in 1982 with surgical technique. Since then, these devices have permitted infusion of total parenteral nutrition, antibiotics, blood products, and, above all, they have definitively changed the quality of life of patients with cancer. However, with the increase of percutaneous procedures, we have assisted with a concomitant raise of immediate postprocedural life-threatening complications. The aim of this study was to review the literature during a 27-year period, with regard to the changes of incidence of immediate complications after percutaneous or surgical cutdown for TIVAD’s implant. Materials and Methods An extensive search of relevant literature was carried out by using MEDLINE (PubMed) and Google Scholar. We gathered articles from 1982 to 2009 that quoted patient’s number, type of pathology, specialist involved, number of devices implanted, site and technique of implantation (surgical cutdown or percutaneous technique), and immediate complications occurrence. Results A total of 952 reports were screened, and finally only 45 articles addressing all inclusion criteria were used for the present study. A total of 11,430 TIVADs implanted in 11,381 patients were analyzed. Pneumothorax, hemothorax, arterial puncture, and hemoptysis developed only after percutaneous procedures. Atrial fibrillation, hematomas, and malpositioning were more frequent after percutaneous approach. The total amount of immediate complications in patients submitted to percutaneous implant was 4.5%, compared with 0.9% subsequent to cutdown technique. Conclusions Despite the increased use of percutaneous technique for TIVADs’ implantation, surgical cutdown, because of its safety, remains the best approach to avoid possible fatal immediate complications.Keywords
This publication has 38 references indexed in Scilit:
- Experience of anesthesiologists with percutaneous nonangiographic venous accessJournal of Clinical Anesthesia, 2007
- Implantation of central venous ports with catheter insertion via the right internal jugular vein in oncology patients—single center experienceSupportive Care in Cancer, 2006
- An alternative technique for totally implantable central venous access devices. A retrospective study of 1311 casesEuropean Journal of Surgical Oncology, 2006
- Surgical technique for totally implantable access ports (TIAP) needs improvement: A multivariate analysis of 400 patientsJournal of Surgical Oncology, 2005
- Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patientsBreast Cancer Research and Treatment, 2005
- Immediate and long-term complications of prolonged-venous-access devices (PVAD): A comparison between surgical cutdown and percutaneous techniquesInternational Journal of Angiology, 2004
- Totally implantable subcutaneous port system versus central venous catheter placed before induction chemotherapy in patients with acute leukaemia?a randomized studySupportive Care in Cancer, 2004
- Morbidity Associated with Long‐Term Use of Totally Implantable Ports in Patients with AIDSClinical Infectious Diseases, 1999
- Alternative insertion sites for permanent central venous access devicesEuropean Journal of Surgical Oncology, 1997
- Implantable catheter system for long-term intravenous chemotherapyJournal of Surgical Oncology, 1989