Surgically implanted subcutaneous venous access devices in cancer patients

Area of Science:

• Oncology
• Vascular Surgery
• Medical Devices

Background:

• Patients undergoing chemotherapy often require long-term central venous access.
• Peripheral venous access can be challenging due to inadequate veins or recurrent thrombophlebitis.
• Implanted venous access devices (e.g., Port-A-Cath) provide a solution for prolonged venous access with reduced patient discomfort.

Purpose of the Study:

• To evaluate the safety and efficacy of surgically implanted venous access devices using a venous cut-down technique in cancer patients.
• To assess the complication rates and functional outcomes of this implantation method.

Main Methods:

• Forty-nine Port-A-Cath devices were implanted subcutaneously in 45 cancer patients.
• A venous cut-down technique was employed to avoid pneumothorax risk.
• Implantations were primarily in the deltopectoral groove under local anesthesia with lidocaine 0.5%, guided by fluoroscopy.

Main Results:

• The cumulative function time was 22.6 patient-years (1177 weeks), with a mean function time of 24 weeks.
• No serious complications were observed.
• Two local infections and four occlusions occurred; patency was restored in three of the four occluded devices.

Conclusions:

• Surgical implantation of venous access devices via a venous cut-down technique is a safe and effective method for establishing central venous access in cancer patients.
• This technique offers a low complication rate compared to percutaneous catheters or arteriovenous fistulas.
• It provides a reliable option for long-term venous access with minimal patient discomfort.