Handling measures for the implantable vascular access device to prevent of catheter fracture/disruption

This study aims to investigate the causes of catheter fracture and handling measures for implantable vascular access devices to prevent catheter fracture. We retrospectively examined 3088 adult patients with catheter fracture/disruption caused by totally implantable vascular access devices (TIVDs). In the 3088 cases, implantation was via the internal jugular vein in 2909 cases and the subclavian vein in 179 cases. Catheter fracture/disruption occurred in 13 patients (0.42%). In 7 cases in which implantation was via the internal jugular vein (left side, n = 4 and right side, n = 3), the incidence of catheter fracture/disruption was 0.24% (7/2909). Four patients had catheter fracture, and 3 patients had catheter disruption. Among those with subclavian venipuncture, 6 patients had catheter fracture/disruption, with an incidence rate of 3.35% (6/179), including 4 cases of implantation via the left side and 2 cases of implantation via the right side. The incidence of catheter fracture/disruption in the internal jugular venipuncture was significantly lower than that in the subclavian venipuncture (χ2 = 38.938, P = 0.000). All of the cases of catheter fracture/rupture were treated safely, without any deaths in all the patient groups. Acutenes activity, body shape, improper operation, catheter material, and special anatomical structure are the causes of catheter fracture/disruption. Performing the appropriate surgical method and informing patients to avoid strenuous activities could reduce the incidence of catheter fracture/disruption.