Evaluation of the position of the central venous catheter tip of implantable venous access devices in the occurrence...

Area of Science:

• Medical Devices
• Oncology
• Vascular Access

Background:

• Totally implantable venous access devices (TIVADs) are crucial for cancer patient treatment.
• Incorrect TIVAD catheter tip positioning is a known risk factor for complications.
• Assessing complications related to TIVAD tip position is vital for patient safety.

Purpose of the Study:

• To evaluate early and late complications (EC and LC) in cancer patients undergoing TIVAD placement.
• To determine the association between TIVAD catheter tip position and the incidence of complications.
• To identify specific risk factors for TIVAD-related complications.

Main Methods:

• Retrospective review of cancer patients with TIVADs implanted in 2020.
• Categorization of complications into EC (≤90 days) and LC (>90 days).
• Chest X-ray analysis to assess vertical catheter tip mismatch relative to the carina and right main bronchus (RMB).

Main Results:

• 11.3% of patients experienced EC, and 5.6% had LC.
• Catheter tips positioned ≤10 mm below the carina were associated with significantly higher EC rates (18.3% vs. 8.6%).
• Left internal jugular vein (IJV) insertion was linked to increased EC risk (19.1% vs. 9.0%).

Conclusions:

• TIVAD catheter tip proximity to the carina (≤10 mm) is a significant risk factor for EC.
• Left-sided IJV catheter insertion independently increases the risk of early complications.
• Optimizing TIVAD tip placement and insertion side can mitigate early complication risks.