title: Radio-opacity and incidental identified mechanical complications of totally implantable venous access devices placed in the chest.
abstract: BACKGROUND
  Totally implantable venous access devices (TIVAD) may be associated with different complications. Certain mechanical port disorders can easily be diagnosed on chest radiographs if the implanted systems are radiopaque and well visible. There are no reports regarding the visibility of TIVAD on chest X-rays.
  
  
  OBJECTIVE
  To assess the radio opacity of TIVAD implanted in the chest as well as type and frequency of mechanical complications of ports on chest X-ray images.
  
  
  METHODS
  Chest X-rays of 985 patients from the time period 2007-2009 were analyzed retrospectively. In these patients 1190 TIVAD were inserted. All parts of the TIVAD, i.e. port chamber, connection, and port catheter, were checked for their visibility on chest radiographs. An opacity score was used here as follows: ++ well visible; + visible; - partly or completely invisible. Mechanical complications of TIVAD incidentally detected on chest X-ray were also analyzed retrospectively.
  
  
  RESULTS
  Nineteen TIVAD models with diverse configuration and visibility of port chambers, connections, and catheters were identified in our study. Eighty-eight percent of the analyzed port systems were well visible or visible on chest radiographs. Twelve percent of the port chambers and catheters were partly visible or completely invisible. In 9% of the TIVAD, different mechanical complications were diagnosed on chest X-ray images.
  
  
  CONCLUSIONS
  TIVADs should be evaluated carefully on every chest X-ray. Ideally, they should be radio-opaque and well visible on thoracic X-ray images. Unfortunately, this is not always the case. Therefore, manufacturers of TIVAD should take into consideration to use exclusively radio-opaque materials that allow sufficient visibility of each port component on chest radiographs.
authors.affiliation: Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany. alex.surow@medizin.uni-halle.de
authors.forename: Alexey
authors.initials: A
authors.lastname: Surov
authors.forename: Carsten
authors.initials: C
authors.lastname: Rusner
authors.forename: Karl
authors.initials: K
authors.lastname: Weigand
authors.forename: Endres
authors.initials: E
authors.lastname: John
authors.forename: Rolf Peter
authors.initials: RP
authors.lastname: Spielmann
authors.forename: C
authors.initials: C
authors.lastname: Behrmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012307:Risk Factors; D062666:Vascular Access Devices / Q000009:adverse effects*