Open AccessPredictive risk factors for fracture at catheter of totally implantable venous access devices via subclavian vein insertion
Author(s) -
Hyo Won Chang,
Chou Yc,
ShengDer Hsu,
GuoShiou Liao,
T-W Chen,
CB Hsieh,
Chen Cj,
Jiang Yu,
De-Chuan Chan
Publication year - 2014
Publication title -
yīxué yánjiū zázhì/journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.176
H-Index - 12
eISSN - 2542-4939
pISSN - 1011-4564
DOI - 10.4103/1011-4564.139186
Subject(s) - catheter , clavicle , medicine , surgery , port (circuit theory) , venous access , complication , subclavian vein , univariate analysis , multivariate analysis , electrical engineering , engineering
Background: Fracture of totally implantable venous access devices (TIVAD) is a rare but potential serious complication. We aimed to explore the risk factors for fracture at catheter of TIVAD via subclavian vein insertion. Materials and Methods: From January 2008 to July 2010 the records of 34 patients with fractured TIVAD were retrospectively reviewed. The comparison group included 170 randomly selected cases (5 for every patient with a fractured catheter) from 3919 cases of TIVAD implantations without catheter fracture. Variables associated with catheter implantation and the relationship between the catheter and the clavicle were analyzed. Results: Statistical analysis revealed implantation method, duration of implantation, brand of device, and port-clavicle distance were predictive risk factors for catheter fracture on univariate analysis. Duration of implantation >200 days and port-clavicle distance <2.5 cm were independent risk factors for catheter fracture on multivariate analysis. Stratified analysis indicated that a port-clavicle distance <2.5 cm in patients with duration of TIVAD implantation >200 days was associated with a significantly increased risk of catheter fracture. Conclusions: We suggested that TIVAD with a port-clavicle distance <2.5 cm could be removed to prevent catheter fracture when the implantation duration is more than 200 days