VASCULAR ACCESS BY PHYSICIAN ASSISTANTS - EVALUATION OF AN IMPLANTABLE PERIPHERAL PORT SYSTEM IN CANCER-PATIENTS

Purpose: To determine the ability of a physician assistant (PA) to ins ert, in an ambulatory setting, a peripheral subcutaneous implanted vas cular-access device (VAD) and to evaluate the ability to transfer this training to a second PA. We also evaluated the performance and compli cations associated with this new device. Patients and Methods: The per ipheral Access System (PAS) Part catheter system (Sims-Deltec Inc, St Paul, MN) was inserted in patients who required long-term (>3 months) vascular access for infusion therapy. Results: The first PA (PA-1) suc cessfully inserted 57 of 62 devices (92%) after gaining experience wit h the technique in 10 patients (success rate, five of 10 (50%); P = .0 03). The second PA (PA-2) was successful in eight of 10 initial attemp ts (80%) and 25 of 30 overall (83%), Complications were few and limite d to phlebitis, thrombosis, and a low infection rate (0.2 per 1,000 ca theter days), Conclusion: PAs can be taught to insert a peripheral sub cutaneous implanted VAD. This technique is transferable from one PA to another, and the device studied is appropriate for outpatient VAD pro grams. (C) 1995 by American Society of Clinical Oncology.