Difficult removal of totally implantable venous access devices in adult patients: Incidence, risk factors, and management

• Published in: The journal of vascular access 2023-09, Vol.24 (5), p.1150-1157
• Main Authors: Chatani, Shohei, Tsukii, Ryota, Nagasawa, Kyohei, Hasegawa, Takaaki, Murata, Shinichi, Kato, Mina, Yamaura, Hidekazu, Onaya, Hiroaki, Matsuo, Keitaro, Watanabe, Yoshiyuki, Inaba, Yoshitaka
• Format: Article
• Language: English
• ISSN: 1129-7298; 1724-6032
• DOI: 10.1177/11297298211069256

Background: Totally implantable venous access devices (TIVADs) have played an important role of medical oncology practice. However, operators sometimes encounter considerable difficulty when removing TIVADs. This study aimed to investigate the incidence of difficult TIVAD removal, determine associated risk factors, and investigate interventional radiology (IR) approaches to difficult removal. Methods: A total of 514 TIVAD removal procedures performed in a single-center between January 2014 and May 2021 were retrospectively analyzed to determine incidence of difficult removal and associated risk factors. IR approaches applied in difficult removal cases were also reviewed. Results: The incidence of difficult removal was 7.4% (38/514). In univariable analysis, indwelling duration, silicone catheter, and subcutaneous leakage of fluid were identified as significant risk factors for difficult removal. Multivariable analysis showed that indwelling duration per year (odds ratio (OR), 1.46; 95% confidence interval (CI), 1.28–1.67; p