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Dynamic Imaging of Chimeric Antigen Receptor T Cells with [18F]Tetrafluoroborate Positron Emission Tomography/Computed Tomography
Published on: February 17, 2022
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When TIVADs Won't Let Go: Lessons Learned From a Pediatric Oncology Cohort in Southern Chile
Albert Pasten1,2, Lucas Alvarado3, Andrea Fernandez4,5
1Department of Surgery, Faculty of Medicine, University of Concepcion, Concepcion, Chile.
European Journal of Haematology
|December 1, 2025
Summary
Prolonged indwelling time and open technique increase mechanical complications during totally implantable venous access device (TIVAD) removal in pediatric oncology patients. Timely removal can mitigate these risks.
Area of Science:
- Pediatric Oncology
- Medical Devices
- Surgical Complications
Background:
- Totally implantable venous access devices (TIVADs) are crucial for pediatric cancer treatment.
- Mechanical complications during TIVAD removal pose a risk to patients.
Purpose of the Study:
- To determine the incidence and risk factors for mechanical complications during TIVAD removal.
- To inform management strategies for elective TIVAD removal in pediatric oncology.
Main Methods:
- Retrospective cross-sectional review of TIVAD removals from June 2022 to May 2025.
- Analysis of demographic, oncologic, and device variables.
- Univariate comparisons to identify associations with mechanical outcomes.
Main Results:
- 29.4% of 68 TIVAD removals had mechanical complications.
- Difficult removal (29.4%) and catheter retention (17.6%) were most common.
- Prolonged indwelling time (mean 5.1 years) was linked to difficult removals and catheter fracture (mean 6.1 years).
Conclusions:
- Extended indwelling time is a key predictor of mechanical complications during TIVAD removal.
- Open surgical technique showed a borderline association with difficult removals.
- Early identification of high-risk devices and timely removal are recommended to prevent complications.
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