{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T18:34:17Z","timestamp":1775241257193,"version":"3.50.1"},"reference-count":17,"publisher":"Royal College of Surgeons of England","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p> Totally implantable venous access devices (TIVADs) are widely used to provide long-term, central venous access for antibiotic delivery in cystic fibrosis patients. However, few studies have demonstrated long-term follow-up with large cohorts. <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> This is a retrospective review of TIVADs implanted in cystic fibrosis patients by vascular surgeons at a tertiary referral centre, using an open venous cut-down technique, from March 1986 to July 2006. The cephalic vein was preferentially chosen for line placement, in the deltopectoral groove, under fluoroscopic control. TIVAD performance (life-span or survival) and complications were evaluated. Data were extracted by review of a local database (data collated prospectively since 1986), with supplementation from electronic patient records and medical notes. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> In total 165 TIVADs in 109 patients (34 males, 75 females) were reviewed. Median survival was 1441 days (range, 6\u20134440 days). Cumulative patency was 146,072 catheter-days. No immediate intrathoracic complications (pneumothorax, haemothorax, nerve injury) occurred. There were 3 early and 82 late complications, namely: occlusion (33 TIVADs; median age 510 days), infection (23 TIVADs; median 376 days), leakage (16; median 283 days), pain or discomfort (6), venous thrombosis (5), extravasation\/skin necrosis (1), vegetation in right atrium (1). Overall incidence of complications was 0.58 per 1000 catheter-days. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p> This study concurs with others that TIVADs are safe and effective, with a favourable life-span in cystic fibrosis patients if well looked after in a specialist centre. Complications of infection, leakage and occlusion do occur. Using an open, venous cut-down technique with fluoroscopic control avoids any immediate intrathoracic complications. <\/jats:p><\/jats:sec>","DOI":"10.1308\/003588408x321684","type":"journal-article","created":{"date-parts":[[2008,11,4]],"date-time":"2008-11-04T03:06:16Z","timestamp":1225767976000},"page":"679-684","source":"Crossref","is-referenced-by-count":30,"title":["Totally Implantable Venous Access Devices \u2013 20 Years' Experience of Implantation in Cystic Fibrosis Patients"],"prefix":"10.1308","volume":"90","author":[{"given":"T James","family":"Royle","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Heartlands Hospital, Heart of England NHS Foundation Trust Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth E","family":"Davies","sequence":"additional","affiliation":[{"name":"West Midlands Adult Cystic Fibrosis Centre, Heartlands Hospital, Heart of England NHS Foundation Trust Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark X","family":"Gannon","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Heartlands Hospital, Heart of England NHS Foundation Trust Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(84)90023-0"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(84)90209-5"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91806-4"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.136.9.1050"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2001.115351"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2005.04.028"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20410"},{"key":"b8","first-page":"305","volume":"58","author":"Rapisarda C","year":"2006","journal-title":"Chir Ital"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2005.09.004"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1053\/rmed.2000.0943"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.12010217"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00052504"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004111"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(84)90340-4"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704022"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1136\/thx.37.11.850"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)00124-5"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/003588408X321684","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T09:59:27Z","timestamp":1684144767000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/003588408X321684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,11]]},"references-count":17,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2008,11]]}},"alternative-id":["10.1308\/003588408X321684"],"URL":"https:\/\/doi.org\/10.1308\/003588408x321684","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,11]]}}}