Totally implantable venous access devices: A restrospective analysis of morbidity and risk factors in a hospital with multi-technique approaches

•Low rate of complications of insertion of TIVAD corroborates the safety and convenience of this procedure.•No superiority relation was established between the different techniques of vascular accesses.•Direct puncture in the subclavian vein or internal jugular vein is associated with more accidental arterial punction comparing to cutdown approach in the cephalic vein. Nevertheless, the latter is traditionally associated with a higher failure rate.•History of previous catheters and shoulder orthopedic pathology or previous local surgeries are risk factors for immediate complications.•Late complications appear more often in older patients and in the ones with history of thoracic disease (breast or lung cancer), chronic pain, shoulder orthopedic pathology or previous local surgeries. Totally implantable venous central access devices (TIVADs) can be implanted by open surgery or by direct puncture in the subclavian (ScV), internal jugular (IJV) or cephalic (CephV) veins. A retrospective study was conducted in 201 patients. Thirty-day follow-up data was analyzed to compare the outcomes of different techniques and evaluation of risk factors. Complications were reported in 3.8 % of the patients with no overall differences between different vascular accesses. Direct puncture was associated with more accidental arterial punction (p = 0.01). History of previous catheters was a risk factor for immediate complications (p = 0.01) and patients with history of thoracic disease had more early and late complications (p = 0.03 and p = 0.04, respectively). Late complications were more common in patients over 60 years old (p = 0.04) and with chronic pain (p = 0.03). There was no difference in overall complication rates between the implantation techniques. Further prospective randomized controlled trials would clarify the most effective technique.