[Totally implantable venous-access systems: apropos of experiences of 30 patients]

Thirty-one totally implantable venous access system were investigated in patients who required intravenous administration of chemotherapy, drugs, nutrients solutions, blood products and blood sampling. Mean duration of venous access was 179 days (ranged from 9 to 429 days). Eight complications were observed, five benign without consequence on port system use, three severe (infections) requiring its removal. No death occurred during implantation and port system use. Patient acceptance was better than with other methods for repeated vascular access. In patients requiring prolonged chemotherapy, totally implantable venous access systems represent a new technique of long term venous access, with easy implantation and lack of restriction of daily activities. Review of literature show that complications are most frequently local and easy to manage. Four types of complications may have severe consequences for patient and/or port system use: catheter occlusion, venous thrombosis, local and/or general infection, and skin necrosis subsequent or not to extravasation. They represent the major cause of port system removal, but this is seldom necessary. Acquired experience allow to justify an earlier implantation of totally implantable venous access systems before chemotherapy and destruction of available surface vessels.