TIVADTotally Implantable Venous Access Device (vascular medicine)
TIVADTotally Implantable Vascular Access Device
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In all patients, postoperative chest radiograph was performed for identifying the location of the TIVAD. The port-clavicle distance was determined by measuring the minimum distance between clavicle and port of the TIVAD [Figure 1].
The rate of catheter fracture was 0.86% (34/3953) among all implanted TIVAD during this period, and all fractured catheters were successfully retrieved by a goose-neck snare device.{Table 1}
The factors that independently correlated with fracture of the TIVAD were duration of implantation >200 days and port-clavicle distance <2.5 cm.
A fractured catheter is a rare, but life-threatening complication, and the incidence of TIVAD fracture has been reported to range from 0.53% to 0.1%.
[sup][27] also reported similar findings regarding the fracture site of TIVAD. The mechanism of catheter fracture over the port-catheter junction may be extrinsic compression near the port-catheter junction combined with material fatigue caused by repeating bending of the catheter with shoulder movement, not pinch-off syndrome.
In univariate analysis, TIVAD implantation method, brand of device, and duration and distance between the port and the clavicle were associated with increased risk of catheter fracture.
[sup][28] We thought that the shape of a TIVAD could be represented by measuring the port-clavicle angle; however, the results of our analysis showed that the port-clavicle angle did not increase the risk of catheter fracture.