Key result
Left-sided TIVAD placement was identified as the only significant independent predictor of shorter device availability (OR 3.5), although overall long-term availability of the devices remained high.
Why the study?
Although totally implantable venous access devices are widely used in medical oncology, their long-term availability and complications require further investigation given prolonged patient needs.
What is the long-term availability and complication rate of totally implantable venous access devices (TIVADs) in adult cancer patients?
Cohort (n=204)
No
What is the long-term availability and complication rate of totally implantable venous access devices (TIVADs) in adult cancer patients?
Odds Ratio: 3.5 (95% CI 1.1–11.1)
p-value: p=0.036
TIVADs in cancer patients demonstrate high long-term availability and low complication rates, suggesting that early removal may not be necessary and right-sided implantation may offer better outcomes.
High long-term TIVAD availability supports continued use in oncology; leaves open optimal site selection and prospective validation.
PURPOSE: Totally implantable venous access devices (TIVADs) currently have an important place in medical oncology practice; however, their long-term availability deserves further investigation, since they are usually required by patients for prolonged periods. This study aimed to evaluate long-term availability of TIVADs in adult cancer patients, in conjunction with complication/removal rates over time and associated risk factors during 7-year follow-up. METHODS: A total of 204 adult cancer patients who underwent TIVAD placement via subclavian vein using the Seldinger technique were included in this study. Medical data and catheter follow-up records were investigated retrospectively. Complications and port removals due to complications were evaluated over time. RESULTS: During median 21.9 (range, 0.7-82.9) months of follow-up, great majority of the patients did not require catheter removal due to complications (91.7%). During a total follow-up of 183,328 catheter days, 20 (9.8%) patients had complications with an incidence of 0.109 cases per 1000 catheter days and 18 (8.8%) of them required TIVAD removal (0.098 cases per 1000 catheter days). Most device removals due to complications (15/18, 83.3%) occurred within the first 24 months. Multivariate analysis identified left-sided device location as the only significant independent predictor of short device availability (OR, 3.5 [95% CI, 1.1-11.1], p = 0.036). CONCLUSION: TIVADs in cancer patients appear to be safe and their availability appears to be high in the long term. A decision for early removal might be revisited. Opting for the accustomed side (right side in the present study) for implantations seems to be associated with better outcomes.
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Tümay et al. (2020) conducted a cohort in Cancer requiring venous access (n=204). Left-sided TIVAD placement vs. Right-sided TIVAD placement was evaluated on Short device availability (catheter removal due to complications) (OR 3.5, 95% CI 1.1-11.1, p=0.036). Left-sided TIVAD placement was identified as the only significant independent predictor of shorter device availability (OR 3.5), although overall long-term availability of the devices remained high.
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