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CardioVascular and Interventional Radiology

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01-06-2012 | Clinical Investigation

Feasibility and Safety of Endovascular Stripping of Totally Implantable Venous Access Devices

Authors: Sam Heye, Geert Maleux, G. A. Goossens, Johan Vaninbroukx, M. Jerôme, M. Stas

Published in: CardioVascular and Interventional Radiology | Issue 3/2012

Abstract

Purpose

To evaluate the safety and feasibility of percutaneous stripping of totally implantable venous access devices (TIVAD) in case of catheter-related sleeve and to report a technique to free the catheter tip from vessel wall adherence.

Materials and Methods

A total of 37 stripping procedures in 35 patients (14 men, 40%, and 21 women, 60%, mean age 53 ± 14 years) were reviewed. Totally implantable venous access devices were implanted because of malignancy in most cases (85.7%). Catheter-related sleeve was confirmed as cause of persistent catheter dysfunction despite instillation of thrombolytics. A technique to mobilize the catheter tip from the vessel wall was used when stripping with the snare catheter was impossible. Technical success, complication rate, and outcome were noted.

Results

A total of 55.9% (n = 19) of the 34 technically successful procedures (91.9%) could be done with the snare catheter. In 15 cases (44.1%), additional maneuvers to free the TIVAD’s tip from the vessel wall were needed. Success rate was not significantly lower before (72.4%) than after (96.7%) implementation of the new technique (P = 0.09). No complications were observed. Follow-up was available in 67.6% of cases. Recurrent catheter dysfunction was found in 17 TIVADs (78.3%) at a mean of 137.7 days and a median of 105 days.

Conclusions

Stripping of TIVADs is technically feasible and safe, with an overall success rate of 91.9%. Additional endovascular techniques to mobilize the distal catheter tip from the wall of the superior vena cava or right atrium to allow encircling the TIVAD tip with the snare catheter may be needed in 44.1% of cases.

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Title: Feasibility and Safety of Endovascular Stripping of Totally Implantable Venous Access Devices
Authors: Sam Heye
Geert Maleux
G. A. Goossens
Johan Vaninbroukx
M. Jerôme
M. Stas
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 3/2012
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-011-0158-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Feasibility and Safety of Endovascular Stripping of Totally Implantable Venous Access Devices

Abstract

Purpose

Materials and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusions

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