A totally implantable venous access system for long-term chemotherapy in children.

A totally implantable venous access system consisting of a subcutaneously placed stainless steel portal with a silicone diaphragm attached to a Silastic elastomer central venous catheter was inserted in 39 children with poor venous access. The devices were utilized for blood drawing and the administration of antineoplastic drugs, parenteral nutritional fluids, antibiotics, and blood products. Cumulative duration of access was 6,724 days (range 5-491, median 172 days). Major complications necessitating removal of the device included catheter sepsis or pocket abscess (7%), catheter clot not responsive to enzyme declotting (5%), and catheter occlusion by too tight a ligature (2%). The system provided easy venous access and permitted full physical activity.