{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:45:37Z","timestamp":1786470337889,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Totally implantable venous access devices (TIVADs) are essential in pediatric oncology but can cause mechanical complications at removal. Identifying risk factors helps guide management and timing of elective removal. Our objective is to describe the incidence and determinants of mechanical complications that occur during the removal of TIVADs in a Chilean tertiary pediatric oncology center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cross\u2010sectional review of all TIVAD removal episodes at Hospital Guillermo Grant Benavente (Concepci\u00f3n, Chile) between June 2022 and May 2025. Demographic, oncologic, and device variables were collected; univariate comparisons examined associations with mechanical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010eight removals were analyzed. Mechanical complications occurred in 29.4% of procedures: difficult removal in 20 cases (29.4%), catheter retention in 12 (17.6%), and catheter fracture in 3 (4.4%). Mean indwelling time was greater in fractured devices (6.1\u2009\u00b1\u20090.6\u2009years) compared with non\u2010fractured devices (4.4\u2009\u00b1\u20091.7\u2009years;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), and longer in difficult removals (5.1\u2009\u00b1\u20091.2 vs. 4.2\u2009\u00b1\u20091.3\u2009years;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Open technique was borderline associated with difficult removal (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.050).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prolonged indwelling time and open technique are the principal factors associated with mechanical problems during TIVAD removal. These findings support early recognition of high\u2010risk devices and consideration of timely replacement or elective removal to reduce avoidable complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ejh.70070","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T07:29:56Z","timestamp":1764574196000},"page":"616-622","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When\n                    <scp>TIVADs<\/scp>\n                    Won't Let Go: Lessons Learned From a Pediatric Oncology Cohort in Southern Chile"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5231-9564","authenticated-orcid":false,"given":"Albert","family":"Pasten","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine University of Concepcion  Concepcion Chile"},{"name":"Pediatric Surgeon, Hospital Guillermo Grant Benavente  Concepcion Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Alvarado","sequence":"additional","affiliation":[{"name":"Bachelor of Science in Nursing, University of Concepcion  Concepcion Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Statistical Engineer, Faculty of Medicine University of Concepcion  Concepcion Chile"},{"name":"Faculty of Engineering San Sebastian University  Concepcion Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Y\u00e9venes","sequence":"additional","affiliation":[{"name":"Pediatric Surgeon, Hospital Guillermo Grant Benavente  Concepcion Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.10.043"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2009.01.033"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.02.001"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241260899"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2025.162445"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000086531.86489.4C"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.05.065"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi111"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-021-01271-7"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.01.050"},{"issue":"4","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1177\/000313481708300414","article-title":"Brief Reports: Vascular Complications in Pediatric Port Removal","volume":"83","author":"Kim J.","year":"2017","journal-title":"American Surgeon"},{"issue":"2","key":"e_1_2_11_13_1","first-page":"61","article-title":"Manejo Conservador de Los Cat\u00e9teres Venosos Centrales Retenidos","volume":"25","author":"Albertos Mira\u2010Marcel\u00ed N.","year":"2012","journal-title":"Cirug\u00eda Pedi\u00e1trica"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-015-3754-4"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2003.50129"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2016.02.021"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820969328"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-017-4103-6"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000392"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(98)90087-2"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2016.04.001"},{"issue":"7","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1016\/j.jpedsurg.2009.03.033","article-title":"A New Technique to Remove a \u2018Stuck\u2019 Totally Implantable Venous Access Catheter","volume":"44","author":"Huang S. 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