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Fully implantable venous access systems Central access systems are a considerable step forward in the treatment of patients with cancer. Experience with totally implantable vascular access systems is reported. Since 1986, 185 reservoir pumps have been implanted. Access was by percutaneous cannulation of the subclavian vein in 130 cases ( 7 0 per cent) and surgical exposure of the external jugular vein in 40 ( 2 2 per cent); other sites of insertion were used in 15 cases ( 8 per cent). The mean duration of use of the reservoirs was 276 (range 1-632) days (total 51 150 catheter-days). The meun number of injections was 390 (range 2-670). The total number of complications, mostly mechanical, was 25 (0.5 per 1000 catheter-days). Fully implantable venous access systems are safe and reliable, and their complications can be prevented with adequate management.

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