Abstract
Background
Totally implantable venous access devices (TIVAD) facilitate repeat intravenous therapy
for children. Many children recover and the device may be removed. Although removal
should be a simple procedure via a single incision, in our experience, this has not
been the case.
Methods
Two hundred consecutive cases of removal of TIVAD from September 2000 to January 2004
at Sophia Children's Hospital, Rotterdam, were reviewed.
Results
Average patient age was 5.9 years. The commonest indication for placement was administration
of chemotherapy (88%); commonest indication for removal was remission of disease (70%).
The median duration in situ of the catheter was 29 months (range, 0.4-91 months).
Complications with removal of the polyurethane catheter of the TIVAD were experienced
in 16% of cases. To enable removal, a second incision was required in 28 patients,
venotomy in 5; the catheter could not be removed in 3. For all complicated removals
the catheter had been in situ for longer than 20 months.
Conclusions
Long-term implantation of TIVAD with polyurethane catheter appears unsuitable owing
to a high incidence of complication at time of removal.
Index words
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Article info
Identification
Copyright
© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
