VASCULAR ACCESS PROBLEMS REVISITED - THE MULTINATIONAL ASSOCIATION OFSUPPORTIVE CARE IN CANCER (MASCC) EXPERIENCE

Despite the increased availability of vascular access devices, there i s limited information regarding their pattern of use in the clinical s etting or the criteria used for their utilization. To obtain this info rmation, we sent questionnaires to MASCC members. Forty-five percent o f the respondents stated that the decision to use vascular access devi ces depended on the drugs used at the beginning of therapy. Another 30 % replied that the decision to use long-term vascular access devices d epended on the status of the patient's veins at the beginning of thera py. Only 12% of those surveyed waited until all the veins were exhaust ed before considering using vascular access devices. Although more tha n half of the professionals surveyed used long-term vascular access de vices in 50% or more of their patients with hematologic malignancies, only 20% used these devices in patients with solid tumors. Features co nsidered most important when selecting long-term vascular access devic es were durability of the device and ease of use for medical personnel . Major limitations of long-term vascular access devices were cost, cl osely followed by patient acceptance. The most common reasons for remo val of vascular access devices were infection and thrombosis. We concl ude that there is a lack of uniform criteria for the utilization of lo ng-term vascular access devices, Cost is a major limitation to the wid er use of this technology. More research is necessary to determine the optimal use of vascular access devices in patients with cancer.