Maintenance of Functionality Without Flushing of Totally Implantable Venous Access Devices: A Presentation of Clinical Cases.

Introduction: The aim of this study was to report experience of treating patients who underwent implantation of a long term totally implantable venous access device (TIVAD) that was not flushed. Methods: Patients who underwent TIVAD implantation between 1995 and 2016 were included in the present study. Sex, age, type of disease, indications, surgeon, device used, choice of venous access, type of procedure, morbidity, and follow up duration were considered. Results: Five hundred and forty-four patients underwent surgical TIVAD implantation. The most common type of disease was solid tumours (508 patients, 93,4%). In 503 patients, the TIVAD was implanted in the cephalic vein. Seven (1.3%) patients were diagnosed with tumour recurrence by an oncologist (5/7 male, median age 57 years). Four (57.1%) patients had recurrent colorectal cancer, and three (42.9%) had recurrent breast cancer. For several months, these patients did not return to the hospital for port flushing. None of these devices were heparinised for 18-24 months; however, no signs of occlusion were detected. Conclusion: This study shows that TIVAD can remain patent without flushing. Moreover, the lack of flushing could be economically advantageous and could provide relief for patients. Therefore, a larger study of this topic is needed.