Surgical technique and biomaterials for totally implanted port catheter systems

The surgeon is frequently requested to perform a long term venous access in patients with chronic medical illness. In recent years the indications for placement of permanent catheter in central veins have expanded considerably. Particularly in cancer patients, permanent catheters are today employed for chemotherapy, home parenteral nutrition or hormone and pain-related drug administration. Various technical strategies can be adopted for a simple clinical requirement, but each one of these is distinguished by dissimilar opportunities and failures; in like manner, several biomaterials and models of permanent port are now available, and each one of these is characterized by different properties. In our opinion, it is necessary to define the gold standard for permanent vascular device placement, making an effort to adapt the best surgical placement strategy and biomaterial to the characteristics of the patient and his/her disease.