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Difficulty removing a totally implantable venous access port: A case report
Jing Chen1, Mu Tang2, Qin-Yuan Han3
1Department of Nursing, Nanchang Medical College, Nanchang 330052, Jiangxi Province, China.
World Journal of Clinical Cases
|May 7, 2025
Summary
Removing a totally implantable venous access port (TIVAP) can be challenging due to adhesions, especially after long-term chemotherapy use. Careful placement can prevent complications and ease TIVAP removal.
Area of Science:
- Oncology
- Vascular Surgery
- Medical Devices
Background:
- Examines challenges in removing totally implantable venous access ports (TIVAPs) for long-term chemotherapy.
- Prolonged TIVAP use can lead to complications like kinking, thrombosis, and tissue adhesions.
Observation:
- A breast cancer patient with bone metastasis experienced difficulty aspirating blood from a 3-year-old TIVAP.
- Initial removal attempts were unsuccessful due to suspected adhesions.
- Successful catheter extraction was achieved in a hybrid operating room.
Findings:
- TIVAP removal challenges are highlighted, particularly for devices inserted via the internal jugular vein.
- Catheter traversal of the sternocleidomastoid muscle may increase adhesion risk.
- Repeated neck movements can exacerbate adhesions, complicating extraction.
Implications:
- Suggests careful TIVAP placement to minimize muscle-related adhesions.
- Emphasizes considering potential long-term removal difficulties during initial insertion.
- Highlights the need for specialized techniques or settings for complex TIVAP removals.
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