Appropriate vascular access for patients with cancer

Abstract

Questions as to how best to meet vascular access needs and safety requirements when caring for patients with cancer occur daily in clinical practice, yet evidence for which methods are optimal is poor. In cancer, use of vascular devices such as peripherally inserted central catheters (PICCs), Hickman-type tunnelled catheters (eg, Hickman), or totally implanted ports (PORTs) is common. Collectively, these are referred to as central venous access devices (CVADs). Hickman and PICCs are catheters with an external segment, in contrast to PORTs, which are totally implanted under the skin. CVADs are rightly referred to as a lifeline for patients with cancer. In addition to chemotherapy, they are used to administer blood products, hydration, parenteral nutrition, antibiotics, and phlebotomy. The devices also improve patients' quality of life by reducing the need for venepunctures. Central venous access devices for the delivery of systemic anticancer therapy (CAVA): a randomised controlled trialFor most patients receiving SACT, PORTs are more effective and safer than both Hickman and PICCs. Our findings suggest that most patients receiving SACT for solid tumours should receive a PORT within the UK National Health Service. Full-Text PDF