Sustained venous access is assuming in increasing importance in the medical and surgical practice for the infusion of antineoplastic agent and parenteral nutrition.
In the past, numerous techniques have been devised to assure venous access including peripheral catheterization, cut-down.
But this method has been limited in long-term use because of local infection, thrombosis, difficulty in administration a high-calory parenteral nutrition.
More recently, Broviac or Hickman catheter has been introduced, of which heavier silicone rubber tubes are integrated with a sheath, having a Dacron felt cuff.
The Dacron cuff allows tissue-ingrowth which functions not cnly to fix the catheter firmly in the subcutaneous tissues but also acts like a barrier to retard infection from the punctured skin wound.
But recently the totally implantable venous access devices have been introduced.
These system enables to reduce the infectious complication by way of disconnecting all the possible route of infection form the surrounding skin.
We had perfomed 14 cases of Port-A-Cath Implantation in the Dept of surgery, Asan Medical Center, from October, 1989 to August, 1991.
1) Patient's diagnoses were 6 cases of leukemia, 2 cases of lung Ca, 1 case of colon Ca, Myeloma, pancrease head Ca, malignant lymphoma. Breast Ca and sarcoma, respectively.
2) The route of catheter insertion were 7 cases of right subclavin vein, 3 cases of left subclavin and right internal jugular vein, and 1 case of left internal jugular vein and all procedure was performed under the local anesthesia through open
procedure and closed puncture.
3) Among 14 cases, one infectious complication was deveoped, and removal of implant was needed to sovle the complication.
4) In remaining 13 cases, al have functioned without complication for as long as two years after implantation.
Therefore, Port-A-Cath is the most ideal and new venous access system that has successfully eradicated the infectious complication peculiar to the venous access procedure.
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