Applying Totally Implantable Venous Access Devices (TIVAD) in Children: the First Iranian Experience

Background:During recent years and paralleling the advances in the treatment of patients requiring chemotherapyor long-term total parenteral nutrition (TPN), it has been necessary to provide a chronic central venous access with a low complication rate and long-term availability (months or even years).In our country, this procedure is performed and its technique is refined, but its advantages and complicationshave not been analyzed and reported.Materials and Methods:The records of 120 patients who had undergone TIVAD placement in Mofid children’s hospital, Tehran from 1999 to 2005 were retrospectively reviewed. Outcomes and compliance of parents and therapeutic team were evaluated.Results: There were 120 patients, 68 boys (56.6%) and 52 girls (43.3%); with the age range of 3 months to 13 years old. The following postoperative complications were encountered; withdrawal occlusion in 4 patients (3.3%), intraluminal fibrin sheath in one patient (0.8%), severe neutropenia in 3 patients (2.4%), complete intraluminal occlusion of the catheter in one patient (0.8%), fever and chills in 2 patients (1.6%), and catheter dislodgement in only one patient (0.8%). All parents and members of the therapeutic team were pleased with the TIVAD (100% acceptance).Conclusions:TIVAD placement can be performed in infants and children of all ages. In cases where a chronicvenous access is needed, the use of this device is appropriate, because of its low complication rate and long-term applicability.