PMID- 24659216
OWN - NLM
STAT- MEDLINE
DCOM- 20140713
LR  - 20211021
IS  - 1433-7339 (Electronic)
IS  - 0941-4355 (Linking)
VI  - 22
IP  - 6
DP  - 2014 Jun
TI  - Totally implantable vascular access devices 30 years after the first procedure. 
      What has changed and what is still unsolved?
PG  - 1705-14
AB  - The first placement of a totally implantable central venous access device (TIVAD) 
      was performed in 1982 at the MD Anderson Cancer Center in Houston by John 
      Niederhuber, using the cephalic vein-exposed by surgical cut-down-as route of 
      access to central veins. After that, TIVADs proved to be safe and effective for 
      repeated administration of drugs, blood, nutrients,and blood drawing for testing 
      in many clinical settings, especially in the oncologic applications. They allow 
      for administration of hyperosmolar solutions, extreme pH drugs, and vescicant 
      chemotherapeutic agents,thus improving venous access reliability and overall 
      patients' quality of life. Despite the availability of a variety of devices, each 
      showing different features and performances, many issues are still unsolved. The 
      aim of this review article is to point out what has changed since the first 
      implant of a TIVAD, and what it is still matter of debate, thus needing more 
      investigation. Topics analyzed here include materials, choice of the veins and 
      techniques of implantation, role of ultrasound (US) guidance in central venous 
      access, position of catheter tip assessment, TIVAD-related infection and 
      thrombosis, and quality of life issues.
FAU - Biffi, Roberto
AU  - Biffi R
FAU - Toro, Adriana
AU  - Toro A
FAU - Pozzi, Simonetta
AU  - Pozzi S
FAU - Di Carlo, Isidoro
AU  - Di Carlo I
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Germany
TA  - Support Care Cancer
JT  - Supportive care in cancer : official journal of the Multinational Association of 
      Supportive Care in Cancer
JID - 9302957
SB  - IM
MH  - Catheter-Related Infections/etiology
MH  - Catheterization, Central Venous/adverse effects/instrumentation/*methods/*trends
MH  - Catheters, Indwelling/microbiology/trends
MH  - Humans
MH  - Vascular Access Devices/microbiology/*trends
EDAT- 2014/03/25 06:00
MHDA- 2014/07/14 06:00
CRDT- 2014/03/25 06:00
PHST- 2013/06/06 00:00 [received]
PHST- 2014/03/09 00:00 [accepted]
PHST- 2014/03/25 06:00 [entrez]
PHST- 2014/03/25 06:00 [pubmed]
PHST- 2014/07/14 06:00 [medline]
AID - 10.1007/s00520-014-2208-1 [doi]
PST - ppublish
SO  - Support Care Cancer. 2014 Jun;22(6):1705-14. doi: 10.1007/s00520-014-2208-1.