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With a TICVAP, there is no need for children to undergo multiple peripheral venipunctures, which may injure the peripheral veins and cause psychological and emotional trauma in children. In particular, TICVAPs are necessary in many chronically ill pediatric patients because of infusion of long-term intravenous therapy. Long venous access devices have been used for various indications such as fluid or intravenous drug administration, blood transfusions, or instillation of toxic chemotherapeutic drugs in oncology. Management of a stuck fragment remains controversial in asymptomatic patients, and we suggest careful, close observation rather than aggressive and invasive treatment.Ī totally implantable central venous access port (TICVAP), also known as a chemoport or cancer port, is a small reservoir connected to a venous catheter positioned in the subcutaneous or muscle layer. We suggest prophylactic catheter exchange before indwell duration of 46 months (area under the curve, 0.949 95% Cl 0.905–0.993) and body weight change up to 9.9 kg (AUC, 0.903 95% Cl 0.840–0.966) to prevent a catheter from becoming stuck, especially in children with rapidly growing acute leukemia. In multivariate logistic regression analysis, indwell duration (odds ratio, 1.13 95% confidence interval 1.02–1.37, p = 0.10), body weight change during indwell (OR, 1.00 95% Cl 0.83–1.18, p = 0.97), and platelet count at TICVAP insertion (OR, 0.98 95% Cl 0.95–0.99 p = 0.48) showed an increased trend of risk for a stuck catheter. Indwelling duration and body weight change during TICVAP indwelling were significantly longer and larger in Group S, respectively (p < 0.001). Compared with the complete removal group (Group N), stuck fragment in Group S were significantly found in patients diagnosed with acute leukemia than those with other diagnoses (p < 0.001). All Group S patients were male and had acute leukemia, and their TICVAPs were used for chemotherapy. ResultsĪmong these, 98 cases in 72 patients involved of TICVAP removal, with 8 patients having had incomplete TICVAP removal resulting in a stuck fragment of the catheter in the central venous system (Group S). We retrospectively reviewed the medical records of 121 patients, including 147 cases of TICVAP insertion, between January 2010 and July 2020. Here, we aimed to analyze the risk factors of stuck fragment of TICVAPs during removal in children and recommend the appropriate periods of use or exchange.

However, many complications associated with TICVAPs have been reported. Totally implantable central venous access ports (TICVAPs) have increasingly been used in pediatric patients because they provide reliable venous access.

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