PERIPHERALLY-PLACED CENTRAL VENOUS ACCESS PORTS - CLINICAL AND LABORATORY OBSERVATIONS

The P.A.S. Port(TM) system is a totally implantable central venous acc ess device consisting of a miniature titanium portal and a 5.8 French catheter that is specifically designed for implantation in the forearm . The configuration of this system combined with its unique placement technology provides a simplified alternative to conventional chest-pla ced systems. Our group has placed a total of 61 P.A.S. Port(TM) device s in 56 patients whose ages ranged from 9 months to 85 years and who w ere followed for a median of 672 days. Over this period of follow-up, these devices have demonstrated a low overall complication rate (13.1% ), an infection rate of 6.6%, median event-free patency of 278 days, a nd exceptional patient acceptance. Placement of the P.A.S. Port(TM) sy stem is easily performed as an outpatient procedure under local anesth esia and requires neither fluoroscopy nor a conventional operating roo m setting. In vitro measurement of infusion pressure across a P.A.S. P ort(TM) and a conventional catheter system revealed much higher resist ance in the peripherally placed device, but this was found to be of no clinical significance because infusion pressures generated by flow ra tes up to 750 mL/hr were well within the limits of clinically availabl e infusion pumps. We recommend the P.A.S. Port(TM) system as a safe, d urable, and effective alternative for patients in whom a chest-placed device is inappropriate or undesired.