{"title":"Totally implantable venous access devices: A restrospective analysis of morbidity and risk factors in a hospital with multi-technique approaches","authors":"Diogo Melo-Pinto , Tatiana Moreira-Marques , Emanuel Guerreiro , Marina Morais","doi":"10.1016/j.sipas.2024.100237","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Totally implantable venous central access devices (TIVADs) can be implanted by open surgery or by direct puncture in the subclavian (ScV), internal jugular (IJV) or cephalic (CephV) veins.</p></div><div><h3>Methods</h3><p>A retrospective study was conducted in 201 patients. Thirty-day follow-up data was analyzed to compare the outcomes of different techniques and evaluation of risk factors.</p></div><div><h3>Results</h3><p>Complications were reported in 3.8 % of the patients with no overall differences between different vascular accesses. Direct puncture was associated with more accidental arterial punction (<em>p</em> = 0.01). History of previous catheters was a risk factor for immediate complications (<em>p</em> = 0.01) and patients with history of thoracic disease had more early and late complications (<em>p</em> = 0.03 and <em>p</em> = 0.04, respectively). Late complications were more common in patients over 60 years old (<em>p</em> = 0.04) and with chronic pain (<em>p</em> = 0.03).</p></div><div><h3>Conclusion</h3><p>There was no difference in overall complication rates between the implantation techniques. Further prospective randomized controlled trials would clarify the most effective technique.</p></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"16 ","pages":"Article 100237"},"PeriodicalIF":0.6000,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666262024000044/pdfft?md5=4a2c892ebed4924920e701b37020f8a4&pid=1-s2.0-S2666262024000044-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery in practice and science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666262024000044","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
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Abstract
Background
Totally implantable venous central access devices (TIVADs) can be implanted by open surgery or by direct puncture in the subclavian (ScV), internal jugular (IJV) or cephalic (CephV) veins.
Methods
A retrospective study was conducted in 201 patients. Thirty-day follow-up data was analyzed to compare the outcomes of different techniques and evaluation of risk factors.
Results
Complications were reported in 3.8 % of the patients with no overall differences between different vascular accesses. Direct puncture was associated with more accidental arterial punction (p = 0.01). History of previous catheters was a risk factor for immediate complications (p = 0.01) and patients with history of thoracic disease had more early and late complications (p = 0.03 and p = 0.04, respectively). Late complications were more common in patients over 60 years old (p = 0.04) and with chronic pain (p = 0.03).
Conclusion
There was no difference in overall complication rates between the implantation techniques. Further prospective randomized controlled trials would clarify the most effective technique.