Key result
Re-accessing a TIVAD abandoned for 5 years succeeds without adverse reactions after multidisciplinary team efforts.
Why the study?
Regular flushing and locking of TIVADs is recommended to maintain patency, but the feasibility of re-accessing a port unused and unmaintained for years was illustrated.
Case Report (n=1)
No
A totally implantable venous access device can potentially be successfully re-accessed without adverse outcomes even after 5 years of abandonment, suggesting prolonged flushing intervals may be feasible.
May support extended port flushing intervals; hypothesis-generating case report requiring prospective validation before practice change.
Regular flushing and locking of totally implantable venous access devices (TIVADs) is recommended to maintain their patency when not in use. In this case report, a 73-year-old male patient received radical resection for rectal carcinoma in January 2010. A TIVAD was implanted in 2014 and a total of 12 rounds of chemotherapy of FOLFIRI was completed in 2015. During the period from 2015 to 2020, the patient never used or conducted the monthly infusion port flushing because of the inconvenience, the COVID-19 pandemic, and so on. On 18th April 2020, the patient was admitted to the radiotherapy department of Yiwu Central Hospital. The nurse evaluated the TIVAD upon admission, finding that the skin around the reservoir was normal without any sign of infection as erythema or induration of the skin overlying the implantable port but there was intraluminal occlusion of the devices. In order to re-access the catheter, discussion of a MDT was performed and several days of unremitting efforts were tried. Gratifyingly, the patient's port was re-accessed successfully without any adverse reactions. This is a rare infusion port that has not been used and maintained for 5 years. For the port that has not been used and maintained for a long time up to 5 years, the medical staff should not give up easily. During the COVID-19 pandemic, prolonging the flushing interval of TIVADs can be an optimal clinical strategy without negative outcomes.
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Jiaobo He (2021) conducted a case report in Rectal carcinoma (n=1). Re-accessing an abandoned TIVAD was evaluated on Successful re-access of the TIVAD. A totally implantable venous access device abandoned for 5 years was successfully re-accessed without adverse reactions after multidisciplinary team efforts.
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