Peripherally-placed central venous access ports: clinical and laboratory observations.

The P.A.S. Port system is a totally implantable central venous access device consisting of a miniature titanium portal and a 5.8 French catheter that is specifically designed for implantation in the forearm. The configuration of this system combined with its unique placement technology provides a simplified alternative to conventional chest-placed systems. Our group has placed a total of 61 P.A.S. Port devices in 56 patients whose ages ranged from 9 months to 85 years and who were followed for a median of 672 days. Over this period of follow-up, these devices have demonstrated a low overall complication rate (13.1%), an infection rate of 6.6%, median event-free patency of 278 days, and exceptional patient acceptance. Placement of the P.A.S. Port system is easily performed as an outpatient procedure under local anesthesia and requires neither fluoroscopy nor a conventional operating room setting. In vitro measurement of infusion pressure across a P.A.S. Port and a conventional catheter system revealed much higher resistance in the peripherally placed device, but this was found to be of no clinical significance because infusion pressures generated by flow rates up to 750 mL/hr were well within the limits of clinically available infusion pumps. We recommend the P.A.S. Port system as a safe, durable, and effective alternative for patients in whom a chest-placed device is inappropriate or undesired.