Totally implantable central venous access for cancer patients in Singapore

Sustained venous access is assuming increasing importance in clinical medical practice for the infusion of antibiotics, cytotoxic drugs, blood products and parenteral nutrition. The limitation of peripheral venous access in patients receiving cancer chemotherapy can be a major problem. Many antineoplastic drugs are vesicant and may cause chemical ulcers when infiltrated or phlebitis and thrombosis. Recent technological advances in development of non-thrombogenic silastic catheters have facilitated in-dwelling catheters to be implanted for long periods. Port-A-Cath is a totally implantable vascular access system which allows for blood to be sampled and also infusion of drugs and blood products. Between March 1985 to October 1987, 20 devices were implanted on 19 patients (14 males and 5 females). Criteria were drawn up to select these patients. The quality of life was significantly improved for these patients who receive long term chemotherapy or blood products through this device. There were 6 episodes of transitory occlusion of catheter and 1 episode of infection. Continuous infusion of drugs given through this device does not produce chemical phlebitis. It has also facilitated new methods of delivering cytotoxic drugs and analgesia.