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ORIGINAL ARTICLE
Year : 2014  |  Volume : 34  |  Issue : 4  |  Page : 161-165

Predictive risk factors for fracture at catheter of totally implantable venous access devices via subclavian vein insertion


1 Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taiepi, Taiwan, Republic of China
2 School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China

Correspondence Address:
Dr. De-Chuan Chan
Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Taipei 114, Taiwan
Republic of China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1011-4564.139186

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Background: Fracture of totally implantable venous access devices (TIVAD) is a rare but potential serious complication. We aimed to explore the risk factors for fracture at catheter of TIVAD via subclavian vein insertion. Materials and Methods: From January 2008 to July 2010 the records of 34 patients with fractured TIVAD were retrospectively reviewed. The comparison group included 170 randomly selected cases (5 for every patient with a fractured catheter) from 3919 cases of TIVAD implantations without catheter fracture. Variables associated with catheter implantation and the relationship between the catheter and the clavicle were analyzed. Results: Statistical analysis revealed implantation method, duration of implantation, brand of device, and port-clavicle distance were predictive risk factors for catheter fracture on univariate analysis. Duration of implantation >200 days and port-clavicle distance <2.5 cm were independent risk factors for catheter fracture on multivariate analysis. Stratified analysis indicated that a port-clavicle distance <2.5 cm in patients with duration of TIVAD implantation >200 days was associated with a significantly increased risk of catheter fracture. Conclusions: We suggested that TIVAD with a port-clavicle distance <2.5 cm could be removed to prevent catheter fracture when the implantation duration is more than 200 days.


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