Totally implantable vascular access devices 30 years after the first procedure. What has changed and what is still unsolved?

Roberto Biffi, Adriana Toro, Simonetta Pozzi, Isidoro Di Carlo

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The first placement of a totally implantable central venous access device (TIVAD) was performed in 1982 at the MD Anderson Cancer Center in Houston by John Niederhuber, using the cephalic vein - exposed by surgical cut-down - as route of access to central veins. After that, TIVADs proved to be safe and effective for repeated administration of drugs, blood, nutrients, and blood drawing for testing in many clinical settings, especially in the oncologic applications. They allow for administration of hyperosmolar solutions, extreme pH drugs, and vescicant chemotherapeutic agents, thus improving venous access reliability and overall patients' quality of life. Despite the availability of a variety of devices, each showing different features and performances, many issues are still unsolved. The aim of this review article is to point out what has changed since the first implant of a TIVAD, and what it is still matter of debate, thus needing more investigation. Topics analyzed here include materials, choice of the veins and techniques of implantation, role of ultrasound (US) guidance in central venous access, position of catheter tip assessment, TIVAD-related infection and thrombosis, and quality of life issues.

Original languageEnglish
Pages (from-to)1705-1714
Number of pages10
JournalSupportive Care in Cancer
Volume22
Issue number6
DOIs
Publication statusPublished - 2014

Fingerprint

Vascular Access Devices
Veins
Equipment and Supplies
Quality of Life
Pharmaceutical Preparations
Thrombosis
Catheters
Head
Food
Infection
Neoplasms

Keywords

  • Catheter tip
  • Catheter-related bloodstream infection (CRBSI)
  • Central venous catheter
  • Central venous thrombosis
  • Totally implantable vascular access devices (TIVAD)
  • Ultrasound guidance

ASJC Scopus subject areas

  • Oncology

Cite this

Totally implantable vascular access devices 30 years after the first procedure. What has changed and what is still unsolved? / Biffi, Roberto; Toro, Adriana; Pozzi, Simonetta; Di Carlo, Isidoro.

In: Supportive Care in Cancer, Vol. 22, No. 6, 2014, p. 1705-1714.

Research output: Contribution to journalArticle

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