Permanent subcutaneous vascular access: the chemo shunt.

A technique is described for providing permanent painless vascular access in patients receiving chemotherapy for malignant disorders. In 55 patients with no suitable vascular access, a permanent subcutaneous vascular access site was created in the upper anterior chest wall utilizing a Silastic dome and attached tubing. The drugs to be given are injected into the dome, the solution passes through the tubing and empties into the superior vena cava. When not being used the system is filled with heparin solution. There have been no instances of infection either primarily or in the long term. In some patients the access site has been used for 2 1/2 years and the technique has met with enthusiastic patient response. The author has termed this technique the chemo shunts.