Totally implantable venous access devices in cancer patients

Abstract

Totally implantable venous access devices (TIVDs) are very convenient, long-term accesses to the central venous vessel. They constitute an indispensable solution for patients with difficulties in accessing peripheral veins requiring chemotherapy, parenteral nutrition, antibiotics and frequent blood samples for testing. Port devices are implanted by physicians of different specialties: surgeons, anaesthesiologists, oncologists and radiologists. Vessel cannulation also can be different: open with venotomy or percutaneous puncture. In order to gain access to the central vein: most commonly used are the right internal jugular and right subclavian veins. Implantation of vascular ports as with any interventional treatment, involves the possibility of acute, early and late complications. Acute complications are directly related to the surgery and are the result of abnormal implantation techniques or anatomical abnormalities. Among the late complications in oncology two are particularly troublesome: catheter-related bloodstream infection and thrombosis. Despite their all limitations and complications associated with the use of vascular ports: for more than three decades was no alternative. Further technological development and education of medical staff allows the use of implantable vascular access systems in many patients, giving great benefit to the therapy and improvement of the quality of life of cancer patients.