{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:11:43Z","timestamp":1777936303885,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Removal of totally implanted central venous access devices (brachial ports, chest-ports, femoral ports) is potentially associated with the risk of untoward events, some of them negligible (prolonged maneuver time due to technical difficulties), some relevant (hematoma), and some severe (embolization of catheter fragments into the circulation). The removal technique suitable for minimizing such complications has been described only in few manuals, but it has never been standardized. This paper describes a standardized protocol (SaRePo: Safe Removal of Ports) which consists of seven basic strategies to be adopted systematically during removal of totally implanted venous access devices, so to minimize the risk of adverse events. These strategies include: evaluation of the patient\u2019s history, preprocedural ultrasound scan of the veins, appropriate aseptic technique, proper local anesthesia, catheter extraction, removal of the reservoir from the pocket, closure of the surgical incision.<\/jats:p>","DOI":"10.1177\/11297298251333863","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T02:31:46Z","timestamp":1744684306000},"page":"5-11","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The SaRePo protocol: A seven-step strategy to minimize complications potentially related to the removal of totally implanted central venous access devices"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-1311","authenticated-orcid":false,"given":"Maria Giuseppina","family":"Annetta","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d-IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9926-2128","authenticated-orcid":false,"given":"Fulvio","family":"Pinelli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, University of Florence, \u201cCareggi\u201d Hospital, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Ortiz Miluy","sequence":"additional","affiliation":[{"name":"WoCoVA Scientific Committee, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Scoppettuolo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Catholic University Hospital \u201cA. Gemelli,\u201d Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2225-7654","authenticated-orcid":false,"given":"Mauro","family":"Pittiruti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catholic University Hospital \u201cA. Gemelli,\u201d Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"Guide pratique des chambres \u00e0 cath\u00e9ter implantables","author":"Dupont C","year":"2019","unstructured":"Dupont C, Kriegel I. Guide pratique des chambres \u00e0 cath\u00e9ter implantables. Lamarre Edition, Paris, 2019."},{"key":"e_1_3_2_3_2","volume-title":"Manuale GAVeCeLT Dei Port","author":"Pittiruti M","year":"2024","unstructured":"Pittiruti M, Pinelli F. Manuale GAVeCeLT Dei Port. EDRA, Milano, 2024."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241300792"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241291248"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211067683"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211026825"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241236816"},{"key":"e_1_3_2_9_2","unstructured":"Pittiruti M Scoppettuolo G. Raccomandazioni GAVeCeLT https:\/\/www.gavecelt.it\/nuovo\/sites\/default\/files\/uploads\/raccomandazioni-gavecelt-2024.pdf (2024 accessed January 2024)."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0000000000000532"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2017.09.012"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211026453"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000261"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.24953\/turkjped.2016.02.010"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-022-02656-9"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298221145740"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241260899"},{"issue":"7","key":"e_1_3_2_18_2","article-title":"Asymptomatic spontaneous migration of the tip of Port-a-Cath system into the right internal jugular vein: a case report of an uncommon complication","volume":"14","author":"Diamantidis D","year":"2022","unstructured":"Diamantidis D, Papatheodorou N, Perente S, et al. Asymptomatic spontaneous migration of the tip of Port-a-Cath system into the right internal jugular vein: a case report of an uncommon complication. Cureus 2022; 14(7): e26937.","journal-title":"Cureus"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211039445"},{"issue":"1","key":"e_1_3_2_20_2","article-title":"Endovascular retrieval of a detached and dislocated venous port catheter in the right heart chamber using a triple-loop snare device","volume":"15","author":"Papatheodorou N","year":"2023","unstructured":"Papatheodorou N, Sr Argyriou C, Botaitis S, et al. Endovascular retrieval of a detached and dislocated venous port catheter in the right heart chamber using a triple-loop snare device. Cureus 2023; 15(1): e33681.","journal-title":"Cureus"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211069256"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-021-01271-7"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-015-3754-4"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-017-4103-6"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-024-02630-w"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211072407"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211036002"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211041442"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298221099838"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231209521"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211023275"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43159-023-00254-y"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2024.03.030"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820951035"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000014985"},{"issue":"2","key":"e_1_3_2_36_2","first-page":"3191","article-title":"Handling measures for the implantable vascular access device to prevent of catheter fracture\/disruption","volume":"9","author":"Tang TT","year":"2016","unstructured":"Tang TT, Li YT, Zhang LN, et al. Handling measures for the implantable vascular access device to prevent of catheter fracture\/disruption. Int J Clin Exp Med 2016; 9(2): 3191\u20133196.","journal-title":"Int J Clin Exp Med"},{"issue":"7","key":"e_1_3_2_37_2","article-title":"Supraventricular tachycardia and tricuspid regurgitation in the setting of misplaced implantable port catheter tip","volume":"9","author":"Awan A","year":"2017","unstructured":"Awan A, Ahsan B, Iftikhar H, et al. Supraventricular tachycardia and tricuspid regurgitation in the setting of misplaced implantable port catheter tip. Cureus 2017; 9(7): e1460.","journal-title":"Cureus"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001180"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251333863","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298251333863","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251333863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:26:35Z","timestamp":1777692395000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298251333863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,14]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/11297298251333863"],"URL":"https:\/\/doi.org\/10.1177\/11297298251333863","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,14]]}}}