Totally implanted venous access device removal in interventional radiology.
OBJECTIVE
To demonstrate that totally implanted venous access device (TIVAD) removal in the out-patient interventional radiology (IR) recovery room is safe and effective.


METHODS
Fifty-seven TIVADs were removed in 56 patients using a standard cut-down technique. Forty-one devices (72%) in 40 patients without signs of pocket infection were closed with primary intention with sub-cuticular absorbable or simple non-absorbable sutures, depending on operator preference. All patients were followed up to assess for bleeding or infection. Sixteen devices (28%) in 16 patients with suspected pocket infection were allowed to heal by secondary intention. These patients were managed with antibiotics and dressing changes until healing was complete. Catheter tips were sent for culture and sensitivity.


RESULTS
TIVADs were removed intact in all 57 cases. There were no cases of air embolism, uncontrolled hemorrhage, retained foreign body or catheter fragmentation. No bleeding or infectious complications were noted in those patients who were allowed to heal with primary intention. Wound closure was accomplished in all patients who were allowed to heal with primary or secondary intention.


CONCLUSIONS
TIVAD removal in an out-patient recovery room by an interventional radiology team is safe and feasible, providing a possible alternative venue for this procedure.
Murthy
R
R
Department of Diagnostic Radiology, University of Maryland Medical System, Division of Vascular and Interventional Radiology, Baltimore 21201, USA.
Wesley
B A
BA
Coldwell
D M
DM
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D020878:Device Removal / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015642:Radiology, Interventional / Q000379:methods*; D016748:Venous Cutdown; D014945:Wound Healing
D000970:Antineoplastic Agents