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Table of Contents
LETTER TO THE EDITOR
Year : 2021  |  Volume : 4  |  Issue : 4  |  Page : 768-769

Totally implantable venous access devices: Handle with care!


Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

Date of Submission07-Nov-2021
Date of Decision12-Nov-2021
Date of Acceptance22-Nov-2021
Date of Web Publication29-Dec-2021

Correspondence Address:
Devayani Niyogi
Department of Surgical Oncology, Tata Memorial Hospital, Dr. Ernest Borges Road, Parel, Mumbai 400 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_265_21

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How to cite this article:
Niyogi D, Tiwari V. Totally implantable venous access devices: Handle with care!. Cancer Res Stat Treat 2021;4:768-9

How to cite this URL:
Niyogi D, Tiwari V. Totally implantable venous access devices: Handle with care!. Cancer Res Stat Treat [serial online] 2021 [cited 2022 Jan 20];4:768-9. Available from: https://www.crstonline.com/text.asp?2021/4/4/768/334209



We congratulate Chandveettil et al.[1] for their elegant article published in Cancer Research, Statistics, and Treatment. Totally implantable venous access devices (TIVADs) are being increasingly used in cancer care centers worldwide and have almost replaced peripheral access for patients requiring long-term intravenous access. This detailed analysis of 34 patients with TIVADs inserted in a single center and the rigorous follow-up involved is commendable.

This study reported an 18.9% complication rate associated with the use of TIVADs. This percentage is a tad worrisome. However, if we were to meticulously analyze the complications in centers worldwide such as Chandveettil et al. have done, we would be surprised if any center reported differently. These devices, although a boon for most indications, do come with disastrous complications from a seemingly innocuous indication like venous access. The infection rate in this study (3/34, 8.8%) was quite low, which stands in testimony to the excellent care provided not only by the surgeons but also by the nursing staff in the central venous access device clinic. Kudos! The salvage of an exposed chamber with a local rotation flap also piqued our interest. However, we were pleasantly surprised by the lack of any intra-operative complications during the catheter insertions.

Most of the catheters inserted in this study were for patients with breast cancer. Considering only three ports were left-sided, we are interested to know how the authors decided to site their ports with respect to the laterality of the disease. Would they consider placing a port on the same side as a mastectomy, at the same time? Would they site the chamber differently?

Again, we congratulate the authors on a well-written, detailed review and hope to see a follow-up article with an increased number of patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Chandveettil J, Kattepur AK, Pareekutty NM, Alapatt JJ, Mathiyszhakhan AR, Kumbakaa R, et al. Totally implantable venous access devices in cancer chemotherapy: A retrospective analysis of 8421 catheter days in a tertiary cancer center. Cancer Res Stat Treat 2021;4:449-55.  Back to cited text no. 1
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