ABSTRACT
Most patients with cancer will undergo multiple courses of chemotherapy and other intravenous infusions as a part of their management. Venous access can become compromised by the intravenous cytotoxic chemotherapies, transfusions, hyperalimentation, and other fluids. In 1972, Cole and colleagues reported on the first surgically implanted vascular access device based on a modification of an arteriovenous fistula catheter for renal dialysis. This was later modified and made popular by Broviac and Hickman. A decade later, a completely implanted device known as the Port-a-Cath (PAC) was introduced. Newer devices (PowerPort®) now allow for powered injection of contrast media and can be used for CT pulmonary angiogram. These devices have become more popular as a greater variety of chemotherapeutic options have become available to patients. The advantage of venous access ports includes fewer access failures with less access-related anxiety and pain. With the advent of intraperitoneal chemotherapy, PAC devices became a means of obtaining intraperitoneal access. This chapter discusses the indications, techniques of insertion, complications, and management of complications for these venous access devices.
