Totally implantable venous access devices: A fifteen-year single-center experience

Year 2025, Volume: 11 Issue: 2, 260 - 269

Berkay Kılıç , Burak İlhan , Hasan Karanlık

https://doi.org/10.18621/eurj.1605919

Abstract

Objectives: Totally implantable venous access devices (TIVADs) are frequently used in cancer patients, offering significant comfort and advantages. This study aims to evaluate the outcomes of patients who underwent port catheter placement.

Methods: Data from 3,774 patients who underwent venous port catheter placement between 2007 and 2022 were reviewed. Demographic information, primary diagnoses, port placement locations, number of punctures, complications, and reasons for removal were recorded.

Results: The median age of the patients was 54 years (range: 18-86 years). Catheters were placed on the right side in 3,667 patients (97.2%). The most commonly used vessel was the right subclavian vein, accessed in 2,494 patients (66.1%). Complication rates were observed as follows: femoral vein (40%), brachial vein (20%), subclavian vein (12.1%), internal jugular vein (9.9%), and external jugular vein (6.5%). The complication rate following a single puncture was 7.4%, compared to 16.1% for multiple punctures, showing a significant increase with the number of punctures (P=0.03). The most common early complication in 142 (3.8%) patients was arterial puncture with bleeding or hematoma, while the most common late complication was catheter infection of 1.4% (n=54).

Conclusions: Venous port catheter placement is generally safe, with the right subclavian vein being the most commonly used site. Ultrasound-guided placement reduces complications, which are more frequent with multiple punctures and left-side placements. Early complications like arterial puncture were more common, while late complications were primarily catheter infection.

Keywords

Totally implantable venous access devices, port catheter, subclavian vein

Ethical Statement

The ethics committee approval for the study was obtained from the Istanbul Faculty of Medicine Ethics Committee Unit on 03.09.2024 with number 2834775.

References

• 1. Türkiye Kanser İstatistikleri 2018. https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/Dokumanlar/Istatistikler/Kanser_Rapor_2018.pdf. Accessed September 13, 2024.
• 2. Niederhuber JE, Ensminger W, Gyves JW, Liepman M, Doan K, Cozzi E. Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery. 1982;92(4):706-712.
• 3. Kurul S, Saip P, Aydın T. Totally implantable venous-access ports: local problems and extravasation injury. Lancet Oncol. 2002;3(11):684-692. doi: 10.1016/s1470-2045(02)00905-1.
• 4. Pinelli F, Cecero E, Degl'Innocenti D, et al. Infection of totally implantable venous access devices: A review of the literature. J Vasc Access. 2018;19(3):230-242. doi: 10.1177/1129729818758999.
• 5. Karanlik H, Odabas H, Yildirim I, et al. Is there any effect of first day usage of a totally implantable venous access device on complications? Int J Clin Oncol. 2015;20(6):1057-1062. doi: 10.1007/s10147-015-0830-7.
• 6. Karanlik H, Kurul S, Saip P, et al. The role of antibiotic prophylaxis in totally implantable venous access device placement: results of a single-center prospective randomized trial. Am J Surg. 2011;202(1):10-15. doi: 10.1016/j.amjsurg.2010.05.005.
• 7. Gonda SJ, Ruizong Li R. Principles of subcutaneous port placement. Tech Vasc Interv Radiol. 2011;14(4):198-203. doi: 10.1053/j.tvir.2011.05.007.
• 8. van Loon FHJ, Buise MP, Claassen JJF, Dierick-van Daele ATM, Bouwman ARA. Comparison of ultrasound guidance with palpation and direct visualisation for peripheral vein cannulation in adult patients: a systematic review and meta-analysis. Br J Anaesth. 2018;121(2):358-366. doi: 10.1016/j.bja.2018.04.047.
• 9. Üstüner MA, İlhan E, Zengel B, Telciler KE, Ertürk Ö, Tanrıverdi HO. [Using of venous port catheter in patıents with cancer: a 5-year clinical experience]. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2013;17(4):198-205. [Article in Turkish]
• 10. Güven C. [The evaluation of subcutaneous venous port catheter applications: 6 years of our clinical experience]. ADYÜ Sağlık Bilimleri Derg. 2020;6(1):29-40. doi: 10.30569.adiyamansaglik.624148. [Article in Turkish]
• 11. Machat S, Eisenhuber E, Pfarl G, et al. Complications of central venous port systems: a pictorial review. Insights Imaging. 2019;10(1):86. doi: 10.1186/s13244-019-0770-2.
• 12. Biffi R, Pozzi S, Cenciarell S, Zambelli M, Andreoni B. Treatment of pneumothorax as a complication of long-term central venous port placement in oncology patients. An observational study. J Vasc Access. 2001;2(3):129-136. doi: 10.1177/112972980100200309.
• 13. Yıldızeli B, Laçin T, Batirel HF, Yüksel M. Complications and management of long-term central venous access catheters and ports. J Vasc Access. 2004;5(4):174-178. doi: 10.1177/112972980400500407.
• 14. Capaccioli L, Nistri M, Distante V, Rontini M, Manetti A, Stecco A. Insertion and management of long-term central venous devices: role of radiologic imaging techniques. Radiol Med. 1998;96(4):369-374.
• 15. Teja B, Bosch NA, Diep C, et al. Complication Rates of Central Venous Catheters: A Systematic Review and Meta-Analysis. JAMA Intern Med. 2024;184(5):474-482. doi: 10.1001/jamainternmed.2023.8232.
• 16. Waiser EM. Venous access ports: indications, implantation technique, follow-up, and complications. Cardiovasc Intervent Radiol. 2012;35(4):751-764. doi: 10.1007/s00270-011-0271-2.
• 17. Zaghal A, Khalife M, Mukherji D, et al. Update on totally implantable venous access devices. Surg Oncol. 2012;21(3):207-215. doi: 10.1016/j.suronc.2012.02.003.
• 18. Manici M, Darcin K, Isguzar A, Cosarcan SK, Kucukerdem B, Ercelen O. Intravenous Port Catheter Implantation: Retrospective Study in Single Center Experience. JARSS. 2022;30(1):42-47. doi: 10.54875/jarss.2022.18894.
• 19. Cil BE, Canyiğit M, Peynircioğlu B, et al. Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol. 2006;12(2):93-98.
• 20. Liu L, Liu Z, Wang J, et al. Exploring risk factors for totally implantable venous access devices (TIVADs)-related thrombotic occlusion in the off-treatment period. Sci Rep. 2023;13(1):10767. doi: 10.1038/s41598-023-37902-7.
• 21. Kartsouni V, Moschouris H, Bersimis F, Gkeneralis G, Gkei M, Dodoura S. Complications of Totally Implantable Central Venous Catheters (Ports) Inserted via the Internal Jugular Vein Under Ultrasound and Fluoroscopy Guidance in Adult Oncology Patients: A Single-Center Experience. Cureus. 2022;14(7):e27485. doi: 10.7759/cureus.27485.
• 22. Guan X, Yan H, Zhang J, Li Y, Zhou Y. Risk factors of infection of totally implantable venous access port: A retrospective study. J Vasc Access. 2023;24(6):1340-1348. doi: 10.1177/11297298221085230.