Experience with 1000 totally implantable venous access systems

Objective: To assess retrospectively duration of functioning and rate of complications of a totally implantable venous access system used for long-term chemotherapy. Patients and methods: Between 1985 and 1993, a central venous access system (Port-a-Cath) had been implanted subcutaneously for long-term chemotherapy in 1000 patients (479 males, 521 females; mean age 49 [15 - 86] years). Follow-up observations lasted until the end of the chemotherapy or the removal of the system. Results: Mean time of functioning of the catheter system was 284 (2-1563) days. The complication rate was 12.8%: catheter infection in 4.9% and catheter thrombosis in 3.2%. A further 4.7% of patients had less common complications (malfunction, catheter dislocation, skin necrosis, catheter break or disconnection, pneumothorax). A total of 119 (11,9%) systems had to be removed because of complications. The rates of infection and of other complications were significantly lower in patients with solid tumours (2 and 4%, respectively) than in those with haematological disease (6 and 8%) (P < 0.05 for each). Conclusion: Totally implantable venous access systems are suitable for long-term chemotherapy and cause few complications.