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

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 associat...

Full description

Saved in:
Bibliographic Details
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
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c384t-1b252a79d0eca5191254f04a9a8b3aa102252429bc8b2af4b97ae578899226713
cites cdi_FETCH-LOGICAL-c384t-1b252a79d0eca5191254f04a9a8b3aa102252429bc8b2af4b97ae578899226713
container_end_page 1157
container_issue 5
container_start_page 1150
container_title The journal of vascular access
container_volume 24
creator Chatani, Shohei
Tsukii, Ryota
Nagasawa, Kyohei
Hasegawa, Takaaki
Murata, Shinichi
Kato, Mina
Yamaura, Hidekazu
Onaya, Hiroaki
Matsuo, Keitaro
Watanabe, Yoshiyuki
Inaba, Yoshitaka
description 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 
doi_str_mv 10.1177/11297298211069256
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2623324244</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_11297298211069256</sage_id><sourcerecordid>2623324244</sourcerecordid><originalsourceid>FETCH-LOGICAL-c384t-1b252a79d0eca5191254f04a9a8b3aa102252429bc8b2af4b97ae578899226713</originalsourceid><addsrcrecordid>eNp9kEtr3TAQhUVJaR7tD-imaJlFnGrG8kPdhbR5QKCbdm3G8rgoteVbSb5w_310uUk3gazmwHznwDlCfAZ1CdA0XwHQNGhaBFC1wap-J06gQV3UqsSjrPO_2APH4jTGR6XQVKA_iOOyUi20oE_E7rsbR2fXKcnA87KlSS6jTEuiadpJN28m8on6ieWW_bJGSdZyjHLgrctCOi9p2Ls3lBz7FL_Je2_dwN7yhQwu_pUj2bSEeCHJD3ImT394zuRH8X6kKfKn53smft_8-HV9Vzz8vL2_vnoobNnqVECPFVJjBsWWKjCAlR6VJkNtXxKBwvzXaHrb9kij7k1DXDVtawxi3UB5Js4PuZuw_Fs5pm520fKUi3Eu1GGNZZkTtM4oHFAblhgDj90muJnCrgPV7RfvXi2ePV-e49d-5uG_42XiDFwegJiLd4_LGnyu-0biE-jNiS0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2623324244</pqid></control><display><type>article</type><title>Difficult removal of totally implantable venous access devices in adult patients: Incidence, risk factors, and management</title><source>Sage Journals Online</source><creator>Chatani, Shohei ; Tsukii, Ryota ; Nagasawa, Kyohei ; Hasegawa, Takaaki ; Murata, Shinichi ; Kato, Mina ; Yamaura, Hidekazu ; Onaya, Hiroaki ; Matsuo, Keitaro ; Watanabe, Yoshiyuki ; Inaba, Yoshitaka</creator><creatorcontrib>Chatani, Shohei ; Tsukii, Ryota ; Nagasawa, Kyohei ; Hasegawa, Takaaki ; Murata, Shinichi ; Kato, Mina ; Yamaura, Hidekazu ; Onaya, Hiroaki ; Matsuo, Keitaro ; Watanabe, Yoshiyuki ; Inaba, Yoshitaka</creatorcontrib><description>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 &lt; 0.01) and subcutaneous leakage of fluid (OR, 6.04; 95% CI, 2.45–14.91; p &lt; 0.01) were significantly associated with difficult removal. In the 38 difficult removal cases, 32 TIVADs could be removed using more dissection and traction than the standard removal method. In the other 6, TIVADs were successfully removed by using several IR techniques, including insertion of a guide wire (n = 1), dissection using an introducer sheath (n = 2), pushing with a dilator (n = 1), and pulling with a snare (n = 2). Conclusion: Difficult TIVAD removal is uncommon. However, operators should expect it when removing long indwelling TIVADs and those with subcutaneous leakage. IR approaches to difficult removal are minimally invasive and can be useful.</description><identifier>ISSN: 1129-7298</identifier><identifier>EISSN: 1724-6032</identifier><identifier>DOI: 10.1177/11297298211069256</identifier><identifier>PMID: 35081814</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><ispartof>The journal of vascular access, 2023-09, Vol.24 (5), p.1150-1157</ispartof><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-1b252a79d0eca5191254f04a9a8b3aa102252429bc8b2af4b97ae578899226713</citedby><cites>FETCH-LOGICAL-c384t-1b252a79d0eca5191254f04a9a8b3aa102252429bc8b2af4b97ae578899226713</cites><orcidid>0000-0001-5080-2333</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924,79235</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35081814$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chatani, Shohei</creatorcontrib><creatorcontrib>Tsukii, Ryota</creatorcontrib><creatorcontrib>Nagasawa, Kyohei</creatorcontrib><creatorcontrib>Hasegawa, Takaaki</creatorcontrib><creatorcontrib>Murata, Shinichi</creatorcontrib><creatorcontrib>Kato, Mina</creatorcontrib><creatorcontrib>Yamaura, Hidekazu</creatorcontrib><creatorcontrib>Onaya, Hiroaki</creatorcontrib><creatorcontrib>Matsuo, Keitaro</creatorcontrib><creatorcontrib>Watanabe, Yoshiyuki</creatorcontrib><creatorcontrib>Inaba, Yoshitaka</creatorcontrib><title>Difficult removal of totally implantable venous access devices in adult patients: Incidence, risk factors, and management</title><title>The journal of vascular access</title><addtitle>J Vasc Access</addtitle><description>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 &lt; 0.01) and subcutaneous leakage of fluid (OR, 6.04; 95% CI, 2.45–14.91; p &lt; 0.01) were significantly associated with difficult removal. In the 38 difficult removal cases, 32 TIVADs could be removed using more dissection and traction than the standard removal method. In the other 6, TIVADs were successfully removed by using several IR techniques, including insertion of a guide wire (n = 1), dissection using an introducer sheath (n = 2), pushing with a dilator (n = 1), and pulling with a snare (n = 2). Conclusion: Difficult TIVAD removal is uncommon. However, operators should expect it when removing long indwelling TIVADs and those with subcutaneous leakage. IR approaches to difficult removal are minimally invasive and can be useful.</description><issn>1129-7298</issn><issn>1724-6032</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kEtr3TAQhUVJaR7tD-imaJlFnGrG8kPdhbR5QKCbdm3G8rgoteVbSb5w_310uUk3gazmwHznwDlCfAZ1CdA0XwHQNGhaBFC1wap-J06gQV3UqsSjrPO_2APH4jTGR6XQVKA_iOOyUi20oE_E7rsbR2fXKcnA87KlSS6jTEuiadpJN28m8on6ieWW_bJGSdZyjHLgrctCOi9p2Ls3lBz7FL_Je2_dwN7yhQwu_pUj2bSEeCHJD3ImT394zuRH8X6kKfKn53smft_8-HV9Vzz8vL2_vnoobNnqVECPFVJjBsWWKjCAlR6VJkNtXxKBwvzXaHrb9kij7k1DXDVtawxi3UB5Js4PuZuw_Fs5pm520fKUi3Eu1GGNZZkTtM4oHFAblhgDj90muJnCrgPV7RfvXi2ePV-e49d-5uG_42XiDFwegJiLd4_LGnyu-0biE-jNiS0</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Chatani, Shohei</creator><creator>Tsukii, Ryota</creator><creator>Nagasawa, Kyohei</creator><creator>Hasegawa, Takaaki</creator><creator>Murata, Shinichi</creator><creator>Kato, Mina</creator><creator>Yamaura, Hidekazu</creator><creator>Onaya, Hiroaki</creator><creator>Matsuo, Keitaro</creator><creator>Watanabe, Yoshiyuki</creator><creator>Inaba, Yoshitaka</creator><general>SAGE Publications</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5080-2333</orcidid></search><sort><creationdate>20230901</creationdate><title>Difficult removal of totally implantable venous access devices in adult patients: Incidence, risk factors, and management</title><author>Chatani, Shohei ; Tsukii, Ryota ; Nagasawa, Kyohei ; Hasegawa, Takaaki ; Murata, Shinichi ; Kato, Mina ; Yamaura, Hidekazu ; Onaya, Hiroaki ; Matsuo, Keitaro ; Watanabe, Yoshiyuki ; Inaba, Yoshitaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-1b252a79d0eca5191254f04a9a8b3aa102252429bc8b2af4b97ae578899226713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chatani, Shohei</creatorcontrib><creatorcontrib>Tsukii, Ryota</creatorcontrib><creatorcontrib>Nagasawa, Kyohei</creatorcontrib><creatorcontrib>Hasegawa, Takaaki</creatorcontrib><creatorcontrib>Murata, Shinichi</creatorcontrib><creatorcontrib>Kato, Mina</creatorcontrib><creatorcontrib>Yamaura, Hidekazu</creatorcontrib><creatorcontrib>Onaya, Hiroaki</creatorcontrib><creatorcontrib>Matsuo, Keitaro</creatorcontrib><creatorcontrib>Watanabe, Yoshiyuki</creatorcontrib><creatorcontrib>Inaba, Yoshitaka</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of vascular access</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chatani, Shohei</au><au>Tsukii, Ryota</au><au>Nagasawa, Kyohei</au><au>Hasegawa, Takaaki</au><au>Murata, Shinichi</au><au>Kato, Mina</au><au>Yamaura, Hidekazu</au><au>Onaya, Hiroaki</au><au>Matsuo, Keitaro</au><au>Watanabe, Yoshiyuki</au><au>Inaba, Yoshitaka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Difficult removal of totally implantable venous access devices in adult patients: Incidence, risk factors, and management</atitle><jtitle>The journal of vascular access</jtitle><addtitle>J Vasc Access</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>24</volume><issue>5</issue><spage>1150</spage><epage>1157</epage><pages>1150-1157</pages><issn>1129-7298</issn><eissn>1724-6032</eissn><abstract>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 &lt; 0.01) and subcutaneous leakage of fluid (OR, 6.04; 95% CI, 2.45–14.91; p &lt; 0.01) were significantly associated with difficult removal. In the 38 difficult removal cases, 32 TIVADs could be removed using more dissection and traction than the standard removal method. In the other 6, TIVADs were successfully removed by using several IR techniques, including insertion of a guide wire (n = 1), dissection using an introducer sheath (n = 2), pushing with a dilator (n = 1), and pulling with a snare (n = 2). Conclusion: Difficult TIVAD removal is uncommon. However, operators should expect it when removing long indwelling TIVADs and those with subcutaneous leakage. IR approaches to difficult removal are minimally invasive and can be useful.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>35081814</pmid><doi>10.1177/11297298211069256</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5080-2333</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1129-7298
ispartof The journal of vascular access, 2023-09, Vol.24 (5), p.1150-1157
issn 1129-7298
1724-6032
language eng
recordid cdi_proquest_miscellaneous_2623324244
source Sage Journals Online
title Difficult removal of totally implantable venous access devices in adult patients: Incidence, risk factors, and management
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T10%3A46%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Difficult%20removal%20of%20totally%20implantable%20venous%20access%20devices%20in%20adult%20patients:%20Incidence,%20risk%20factors,%20and%20management&rft.jtitle=The%20journal%20of%20vascular%20access&rft.au=Chatani,%20Shohei&rft.date=2023-09-01&rft.volume=24&rft.issue=5&rft.spage=1150&rft.epage=1157&rft.pages=1150-1157&rft.issn=1129-7298&rft.eissn=1724-6032&rft_id=info:doi/10.1177/11297298211069256&rft_dat=%3Cproquest_cross%3E2623324244%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c384t-1b252a79d0eca5191254f04a9a8b3aa102252429bc8b2af4b97ae578899226713%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2623324244&rft_id=info:pmid/35081814&rft_sage_id=10.1177_11297298211069256&rfr_iscdi=true