# Difficult removal of a totally implantable venous access device 12 years after implantation: a case report and literature review

## TL;DR

A 60-year-old woman had a difficult removal of a 12-year-old implantable venous access device used for breast cancer chemotherapy due to catheter adhesion.

## Contribution

This case highlights the rare but challenging removal of a long-term implantable venous access device due to catheter adhesion.

## Key findings

- The device was successfully removed after careful dissection and traction.
- Prolonged dwell time and catheter adhesion were identified as contributing factors.
- The case emphasizes the need for careful management during long-term device use.

## Abstract

Totally implantable venous access devices (TIVADs) are commonly used for prolonged intravenous treatment, particularly in oncology. Although removal is typically a straightforward procedure at the end of treatment, it can occasionally be complicated by adhesion of the distal end of the catheter to the intravascular wall. This rare complication is often associated with factors such as prolonged catheter dwell time, use of polyurethane material, and younger age at insertion. The technique used for removal depends largely on the degree of adhesion. We report the case of a 60-year-old woman with a TIVAD in place for 12 years for chemotherapy for breast cancer. Removal was challenging due to distal adhesion of the catheter but was ultimately successful following careful dissection and traction.