Technique for placement of a totally implantable venous access device.

A totally implantable venous access system is described which greatly improved the ability to gain long-term venous access in selected patients. The external jugular approach has been demonstrated to be a safe and simple technique. The only major problem associated with the implantable venous access system was the development of one-way catheter occlusions [1]. A number of methods for restoring catheter patency have been advocated [2–4]. The use of streptokinase appears to be the most reliable and was found effective in this study. Importantly, however, catheter sepsis has been virtually eliminated with this totally implantable system.