Totally implantable venous access port (TIVAP), a novel intravenous infusion system that is used for long-term intravenous treatment, has become increasingly popular among cancer patients undergoing chemotherapy and other patients requiring long-term intravenous infusions. This technology has been introduced into clinical practice in China, with successful results. Nevertheless, there are still certain problems; for instance, China has not set up a specialized regulatory agency to oversee research and set guidelines for the comprehensive life-cycle management of TIVAP. Additionally, there exists a disparity in standardized operations and complication management related to TIVAP, which has resulted in variable outcomes, complications, and patient satisfaction with TIVAP implantation across different medical units in China. Therefore, this article aims to provide a systematic overview of the clinical applications and maintenance of TIVAP, both domestically and internationally. Furthermore, this review investigated the latest strategies and associated research on TIVAP implantation and complication management, aiming to provide a basis for standardized surgical and maintenance procedures, protocols to minimize complications, and approaches for enhancing the overall quality of life for patients.

There are many problems of psychological burden in patients with tumor implanted in port of intravenous infusion. However, more attention is paid to its complications in the literature, and psychological problems are seldom concerned. The purpose of this study was to explore the psychological state and needs of tumor patients after implantation of an intravenous infusion port and provide valuable references for psychological interventions.

A semi-structured interview was conducted with 11 patients with intravenous infusion ports. Colaizzi's 7-step analysis was used to analyze the interview data.

According to the primary information, four themes and nine sub-themes were extracted: (1) lack of self-worth, (2) multiple emotional experiences (guilt, doubt, worry, and gain). (3) Poor self-management and self-maintenance awareness (over-reliance on medical staff, unchanged family roles, lack of related knowledge). (4) Expectations and suggestions for the future (inner expectations, suggestions for infusion ports).

The patient's psychological state should be carefully monitored during tube implantation, to relieve the patient's tension and anxiety and improve nursing satisfaction and patient outcomes.

The number of patients with malignant tumors is increasing in China, and venous access ports have unique advantages for chemotherapy. Currently, China's research on venous access port-mediated kinesiophobia is still in the developing stage. Using the combination of subjective words and freedom words, and based on literature traceability methods, China National Knowledge Infrastructure (CNKI), Wanfang, Vipp, Chinese Biomedical Database (CBM), Web of Science, The COCHRANE LIBRARY, Embase, and PubMed were searched. Relevant articles published from the construction of the database to October 30, 2023, were identified. Based on the many articles and analyses, the methods of assessing kinesiophobia in malignant tumors patients using venous access port, the related influencing factors and the preventive and intervention strategies were collated. We found 33 articles examining kinesiophobia in oncology patients, of which 4 were specifically conducted on patients with malignant tumors using VAPs or PICCs. The relevant preventive and therapeutic experiences regarding kinesiophobia in cancer patients with VAP still need improvement. Nursing staff can use assessment tools such as the Tampa Rating Scale for Kinesiophobia, the Fear Avoidance Beliefs Questionnaire, and the Cancer Fatigue Scale to reasonably and effectively assess kinesiophobia among patients with malignant tumors who use VAPs. Attention should be paid to the mechanisms and roles of demographic factors, pain and foreign body sensation, cancer fatigue, pain management strategies, and other factors influencing kinesiophobia. This study provides advice to nursing staff for the management of VAP. Such considerations may reduce the complications of kinesiophobia and improve the quality of life of patients.

Lead-dependent venous occlusion may impede the insertion of a central venous access device (CVAD). The aim of this retrospective, cohort study was to assess the chance of implantation of CVAD in patients with cardiac implantable electronic devices (CIEDs).

We reviewed and analyzed 3,075 venograms of patients with CIEDs undergoing transvenous lead extraction (TLE) between June 2008 and July 2021. Relationship between venous patency and the chance of CVAD placement was estimated.

In 2,318 (75.38%) patients, venography showed no potential obstacles to venous port implantation on the ipsilateral side. In patients with leads on the left side, significant narrowing more often affected the subclavian vein than the brachiocephalic vein [1,595 (55.29%) vs. 830 (28.63%), respectively] or the superior vena cava (SVC) [21 (0.73%) cases]. Furthermore, the subclavian and brachiocephalic veins on the opposite side were also narrowed [35 (2.35%) and 27 (1.24%), respectively]. The chances of port insertion were assessed as easy on CIED side or opposite side in 2,318 (75.38%) and 2,291 (97.91%) patients, respectively), as difficult insertion/questionable performance in 246 (8.00%) and 22 (0.94% patients) and doubtful or impossible insertion/questionable performance in 511 (16.62%)/27 (1.15%) patients with CIED.

(I) Varying degrees of lead-dependent venous obstruction (LDVO) is a frequent finding in patients with CIEDs; (II) the major thoracic veins on the opposite side of the chest may also be significantly narrowed; (III) venography should be considered before attempted CVAD insertion in patients with long lead dwell times or in patients after CIED removal, including planned contralateral port placement.

Implanted intravenous infusion port (TIAP) is mainly used for patients who need central venous infusion and poor peripheral vascular conditions. With the advantages of easy to carry, long maintenance cycle, few complications and excellent quality of life, it has been widely used in the fields of malignant tumor chemotherapy, parenteral nutrition support and repeated blood collection. Implanted intravenous infusion port (IVAP) dislocation can have significant complications if not recognised and reinstated immediately.

A 24-year-old man was treated with adjuvant chemotherapy for osteosarcoma. Severe displacement of IVAP catheter was found by chest X-ray examination. The IVAP cannot be used normally. Therefore, we conducted an emergency procedure to reset the catheter through double pigtail catheters, the operation was successful and the infusion port was restored.

When IVAP catheter displacement cannot be reset by conventional techniques, two pigtail catheters can be successfully used instead.

To summarize the surgical experience of totally implantable venous access port in children with malignant tumors, and to explore the coping methods of surgical complications.

The clinical data of 165 children with malignant tumors implanted in totally implantable venous access port in Department of Pediatric Surgery, Peking University First Hospital from January 2017 to December 2019 were retrospectively analyzed. The operation process, complications and treatment of complications were observed and counted.

The children in this group were divided into external ju-gular vein incision group (n=27) and internal jugular vein puncture group (n=138) according to different surgical methods, and the latter was divided into ultrasound guided puncture group (n=95) and blind puncture group (n=43). No puncture complications occurred in the external jugular vein incision group, and the average time for successful catheterization and the number of times for catheter to enter the superior vena cava were more than those in the internal jugular vein puncture group [(9.26±1.85) min vs. (5.76±1.56) min, (1.93±0.87) times vs. 1 time], with statistical significance. The average time of successful catheterization, the success rate of one puncture, the average number of punctures and the incidence of puncture complications in the ultrasound guided right internal jugular vein puncture group were better than those in the blind puncture group [(5.36±1.12) min vs. (6.67±1.99) min, 93.68% (89/95) vs. 74.42% (32/43), (1.06±0.24) times vs. (1.29±0.55) times, 2.11% (2/95) vs. 11.63% (5/43)], with statistically significant differences. The total incidence of complications in this study was 12.12% (20/165). Pneumothorax occurred in 1 case, artery puncture by mistake in 1 case, local hematoma in 5 cases, venous access port related infection in 4 cases (venous access port local infection in 2 cases, catheter related blood flow infection in 2 cases), subcutaneous tissue thinning on the surface of port seat in 2 cases, port seat overturning in 1 case, poor transfusion in 4 cases (catheter discount in 1 case, catheter blockage in 3 cases), and foreign bodies gathered around the subcutaneous pipeline in 2 cases. There were no complications, such as catheter rupture, detachment and catheter clamping syndrome.

Totally implantable venous access port can provide safe and effective infusion channels for children with malignant tumors. Right external jugular vein incision and ultrasound-guided right internal jugular vein puncture are reliable surgical methods for children's totally implantable venous access port implantation. Surgeons should fully understand the complications of the venous access port, take measures to reduce the occurrence of complications, and properly handle the complications that have occurred.

To summarize the surgical experience of totally implantable venous access port in children with malignant tumors, and to explore the coping methods of surgical complications.

The clinical data of 165 children with malignant tumors implanted in totally implantable venous access port in Department of Pediatric Surgery, Peking University First Hospital from January 2017 to December 2019 were retrospectively analyzed. The operation process, complications and treatment of complications were observed and counted.

The children in this group were divided into external ju-gular vein incision group (n=27) and internal jugular vein puncture group (n=138) according to different surgical methods, and the latter was divided into ultrasound guided puncture group (n=95) and blind puncture group (n=43). No puncture complications occurred in the external jugular vein incision group, and the average time for successful catheterization and the number of times for catheter to enter the superior vena cava were more than those in the internal jugular vein puncture group [(9.26±1.85) min vs. (5.76±1.56) min, (1.93±0.87) times vs. 1 time], with statistical significance. The average time of successful catheterization, the success rate of one puncture, the average number of punctures and the incidence of puncture complications in the ultrasound guided right internal jugular vein puncture group were better than those in the blind puncture group [(5.36±1.12) min vs. (6.67±1.99) min, 93.68% (89/95) vs. 74.42% (32/43), (1.06±0.24) times vs. (1.29±0.55) times, 2.11% (2/95) vs. 11.63% (5/43)], with statistically significant differences. The total incidence of complications in this study was 12.12% (20/165). Pneumothorax occurred in 1 case, artery puncture by mistake in 1 case, local hematoma in 5 cases, venous access port related infection in 4 cases (venous access port local infection in 2 cases, catheter related blood flow infection in 2 cases), subcutaneous tissue thinning on the surface of port seat in 2 cases, port seat overturning in 1 case, poor transfusion in 4 cases (catheter discount in 1 case, catheter blockage in 3 cases), and foreign bodies gathered around the subcutaneous pipeline in 2 cases. There were no complications, such as catheter rupture, detachment and catheter clamping syndrome.

Totally implantable venous access port can provide safe and effective infusion channels for children with malignant tumors. Right external jugular vein incision and ultrasound-guided right internal jugular vein puncture are reliable surgical methods for children's totally implantable venous access port implantation. Surgeons should fully understand the complications of the venous access port, take measures to reduce the occurrence of complications, and properly handle the complications that have occurred.

Catheter-related complications are observed in infusion of chemotherapy, and these were encountered with targeted therapies. Our principle is to study non-mechanical effects of type and initiation time of chemotherapy among the other factors on patency of totally implantable vascular access devices (TIVAD) inserted in patients with colorectal carcinoma.

This is a one-center retrospective cohort study. We analyzed TIVAD related complications in 624 patients with colorectal carcinoma. The patients were categorized by chemotherapy type (non-target-directed chemotherapy agents (Group A), bevacizumab (Group B), and cetuximab (Group C)). Additionally, we divided the patients into groups by the time interval between TIVAD insertion and chemotherapy initiation. According to our study, a 3-day period was optimal. Therefore, we named the groups as within 3 days and beyond 3 days, and called this process 3 days cut-off. Age, gender, jugular-subclavian access, platelet count, INR, the types of chemotherapy, and the initiation time of chemotherapy were investigated by survival tests. We compared chemotherapy type groups both one-by-one and combined into one group.

The TIVADs were removed due to the complications in 11 patients of Group A, 6 patients of Group B, and 3 patients of Group C. Only chemotherapy type was significant (p = 0.011) in Cox regression test. A clear difference (p = 0.010) was detected between the catheter patency of Group A and combination of Groups B and C, because of skin necrosis and thrombosis. Within 3 days of their first chemotherapy day, an important difference between Group A and Group C (p = 0.013) was observed in the TIVAD patency. The same observation was made between Group A and Group B (p = 0.007). Beyond this period, no major difference was detected (p = 0.341).

A major effect on catheter patency was detected by using the target-directed chemotherapy agent within 3 days, which should be considered in target-directed chemotherapy.