Totally implanted device for long-term intravenous chemotherapy: experience in 123 adult patients with solid...

Vascular access in patients receiving prolonged chemotherapy is a difficult problem. This led to the introduction of a totally implanted device. We intend to assess the efficacy of this device in a subset of oncologic patients. Between May 1989 and November 1992, 129 devices were placed in 123 adult patients with solid neoplasms. Most of the catheters were inserted by cut-down of the external jugular vein. Follow-up period ranged from 28 to 70 months. Early complications occurred in 4 of 129 implants, all in percutaneously inserted catheters. Infection was the most frequent late complication. By March 1995, 113 devices had been removed, 15 (13.3%) because of complications. Mean life of the explanted systems was 512 days. Totally implanted devices provide safe and efficient long-term venous access. Implantation should be performed by experienced surgeons, by cut-down whenever possible. Infection is the most serious complication and may be prevented by careful management.