[Complications of central venous access devices: outcome analysis of 2359 implantations]

The implantation of venous access devices is of great importance in the treatment of oncological patients. Such systems allow a safe application of highly efficacious drugs with great comfort for the patient. Knowing the rate of complications, is wide indication for such implantations justified?

From July 1 (st), 1995 to December 31 (st), 2003, 2359 access systems were implanted under local anaesthesia mainly for chemotherapy. All patients were examined for postoperative complications and followed up throughout the complete duration of treatment.

In 147 out of 2359 patients we saw complications which had to be treated. In all cases treatment was effective. No patient suffered severe consequences. Main complications were infections (2.4%), and thrombosis (2.0%). In 17 cases (0.7%) bleeding occurred postoperatively which required reoperation in 12 patients. We saw 5 instances of pneumothorax after puncture of the subclavian vein four of which were drained. In 11 cases (0.5%) we found dislocation of the catheter. In 10 cases we were able to reposition the catheter by open procedure, and only in one patient was repositioning not successful. In three cases (0.1%) there occurred disconnection between access catheter and access chamber with extravasation in two cases. In one patient the catheter had to be removed surgically out of the right atrium.

The implantation of venous access systems under local anaesthesia is a safe procedure with a low rate of complications and allows permanent venous access with very acceptable comfort for the patient. The indication for implantation can therefore be set liberally.