A totally implantable venous access device (TIVAD) consists of two elements – a port chamber, which resembles a thimble, and a catheter, one end of which is connected to the port chamber and the other is located in the vein. It may be considered to be an ever-present artificial vein, one that is not affected by the ‘chemo’. It is located under the skin and is connected to the central vein, near where it enters the right atrium of the heart.
TIVAD enables drug injection and intravenous infusions, but also blood collection for laboratory tests.
Both (joined together) elements of the access device are located underneath the skin and do not require special care once the skin has healed. There is no need for periodic flushing of the access device when it is unused.
Locating it under the skin allows the patient to lead a normal life. After the port implantation procedure is complete and the skin has healed, the patient can bathe, and there is no problem with changing sterile dressings or with special care, as required by other methods of accessing the central veins.
The venous access device should be easy to find for medical personnel, so there is no problem with searching for the vein and multiple punctures. The end of the catheter is located in a place where the blood flow is hundreds times higher than in the peripheral vein. There is no place in the body where the blood flow is higher. Severe irritants (which destroy the veins of the forearm or hand) are immediately diluted and reach the peripheral veins in concentrations that no longer damage the peripheral vein walls.
Totally implantable venous access devices are only recommended by practitioners, although the National Health Fund should require implantation in patients who are scheduled for the use of solutions that irritate peripheral veins. Peripheral access, known as intravenous cannulation, is not an alternative to TIVADs, and its use for chemotherapy, which many last 3 months, should be treated as a medical error.