Expert consensus on the clinical application of totally implantable venous access devices in the upper arm (2022 Edition)

Xiaoxia Qiu,Guangxin Jin,Xuebin Zhang,Lichao Xu, Jinxia Ding, Weisong Li, Lejing Yu, Yapeng Wang, Yanfang Shen, Hongzhi Wang,Jue Wang,Haiping Xu,Weiwei Kong, Lin Yuan,Xuming Bai, Ye Liu,Hong Liu, Ming Cai, Feng Luo,Yiqun Yang

Journal of Interventional Medicine(2023)

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摘要
With the widespread adoption of ultrasound guidance, Seldinger puncture techniques, and intracardiac electrical positioning technology for the placement of peripherally inserted central catheters in recent years, an increasing number of medical staff and patients now accept peripheral placement of totally implantable venous access devices (TIVADs) in the upper arm. This approach has the advantage of completely avoiding the risks of hemothorax, pneumothorax, and neck and chest scarring. Medical specialties presently engaged in this study in China include internal medicine, surgery, anesthesiology, and interventional departments. However, command over implantation techniques, treatment of complications, and proper use and maintenance of TIVAD remain uneven among different medical units. Moreover, currently, there are no established quality control standards for implantation techniques or specifications for handling complications. Thus, this expert consensus is proposed to improve the success rate of TIVAD implantation via the upper-arm approach, reduce complication rates, and ensure patient safety. This consensus elaborates on the technical indications and contraindications, procedures and technical points, treatment of complications, and the use and maintenance of upper-arm TIVAD, thus providing a practical reference for medical staff.
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关键词
Totally implantable venous access device,Upper arm,Central venous catheter,Complication,Maintenance
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