Surgically implanted subcutaneous venous access devices in cancer patients.

Subcutaneously implanted venous access devices allow prolonged access with a minimum of discomfort for patients with inadequate peripheral veins or chemotherapy-induced recurrent thrombophlebitis. In 45 cancer patients, 49 venous access devices (Port-A-Cath) were implanted subcutaneously by means of a venous cut-down technique to avoid the risk of pneumothorax. Most catheters were implanted in the deltapectoral groove under local anaesthesia with lidocaine 0.5% and guided by fluoroscopy. The cumulative function time was 22.6 patient years (1177 weeks), the mean function time 24 weeks (range 0-98 weeks). No serious complications were seen. There were two local infections and four occlusions. The patency could be restored in three of these four. Surgical implantation of venous access devices, under local anaesthesia, is a safe method to establish central venous access in cancer patients. The complication rate is low in comparison with percutaneous catheters or AV-fistulas.