title: Totally implanted venous access devices implanted in the saphenous vein. Relation between the reservoir site and comfort/discomfort of the patients.
abstract: BACKGROUND
  When a totally implantable venous access device (TIVAD) is implanted in the femoral or saphenous vein, the port can be placed in the abdominal wall, thigh, or anteroinferior thoracic wall. This study analyzed the relationship between the position of the port and patient comfort.
  
  
  METHODS
  All patients who underwent TIVAD implantation from 1995 to 2011 were included in the study. Sex, age, indication for TIVAD implantation, contraindication for implantation in a vein draining into the superior vena cava, surgical technique, length of procedure, complications, difficulties recorded by nurses, and patient comfort or discomfort were recorded.
  
  
  RESULTS
  The TIVAD was implanted in the saphenous vein in 6 of 581 patients (1.3%) who received a TIVAD, consisting of four male subjects and two female subjects aged 35 to 56 years (mean age: 47.3 years), who all underwent TIVAD implantation for the treatment of a solid tumor. The port was positioned in the anteroinferior thoracic wall in one patient, the abdominal wall in one patient, the anterior thigh in three patients, and the lateral thigh in one patient. The mean procedure duration was 52 minutes (range: 20-135 minutes). No immediate or early complications were recorded. The nurses had difficulty in puncturing the port in the abdominal wall. Patient comfort levels were high when the port was placed in the anterior thigh.
  
  
  CONCLUSIONS
  The anterior thigh may be the most useful and comfortable position for the port of a TIVAD implanted in the inferior vena cava. Larger studies should be undertaken to confirm this.
authors.affiliation: Department of Surgical Sciences, Organ Transplantation, and Advanced Technologies, Cannizzaro Hospital, University of Catania, Catania, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Toro
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mannino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cappello
authors.forename: Sofia
authors.initials: S
authors.lastname: Celeste
authors.forename: Stefano
authors.initials: S
authors.lastname: Cordio
authors.forename: Isidoro
authors.initials: I
authors.lastname: Di Carlo
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D017060:Patient Satisfaction; D011677:Punctures; D015641:Radiography, Interventional; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D013536:Suture Techniques; D013848:Thigh / Q000601:surgery; D035441:Thoracic Wall / Q000601:surgery; D013997:Time Factors; D062666:Vascular Access Devices / Q000009:adverse effects; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
chemical_list: D000970:Antineoplastic Agents