Right or left? Side selection for a totally implantable vascular access device: a randomised observational study

Area of Science:

• Oncology
• Vascular Surgery
• Medical Devices

Background:

• Complications from totally implantable vascular access devices (TIVADs) disrupt cancer treatment and increase healthcare costs.
• Investigating the impact of TIVAD implantation side on thrombotic or occlusion events is crucial for patient care.

Purpose of the Study:

• To determine if the side of central line TIVAD implantation influences the occurrence of thrombotic or occlusion events.
• To assess the relationship between TIVAD placement side and catheter-related complications in cancer patients.

Main Methods:

• A randomized controlled trial involving cancer patients requiring central line TIVADs.
• Patients were randomized to receive TIVAD implantation on either the left or right side.
• The primary endpoint was the incidence of catheter-related thrombotic or occlusion events.

Main Results:

• Out of 235 patients in the per-protocol cohort, 9 (4%) experienced catheter-related thrombotic or occlusion events.
• No significant difference was observed in the occurrence rates or timing of events between left- and right-sided implantations (P=0.333 and P=0.328, respectively).
• Multivariate analysis confirmed that the implantation side was not associated with thrombotic or occlusion events.

Conclusions:

• The side of central line TIVAD implantation is not linked to the development of catheter-related thrombotic or occlusion events.
• This study indicates that TIVAD placement side does not represent a modifiable risk factor for these common complications in cancer patients.