Totally implantable central venous access devices in adult oncological patients.

Totally implantable vascular access devices (ports) were introduced into clinical practice to replace external catheters in patients undergoing prolonged intravenous therapy. Today, they are also designed to provide repeated access to the vascular system for the delivery of blood products and are also used for the withdrawal of blood samples. As regards cancer patients, the availability of these continuous reliable intravenous catheterisation devices has provided an opportunity to deliver more complex, multi-drug regimens, in safety and with a good quality of life. One hundred and eight patients underwent the subcutaneous positioning of a totally implanted reservoir (via the right subclavian vein) for aggressive combination chemotherapy in an operating room suite, using local anaesthesia. No patients suffered from air embolism, severe bleeding, brachial plexus injury, cardiac tamponade, haemothorax or hydrothorax. No patients experienced catheter occlusion or catheter-related venous thrombosis. One patient suffered from a pocket infection. Two patients experienced pneumothorax, but neither of them required catheter removal or required chest drainage. Indications, contraindications and complications are discussed. With careful routine care, totally subcutaneously implanted ports are very safe and provide reliable access to the venous system.