Vascular access in oncology patients

Authors

  • Dr. Maurizio Gallieni MD,

    1. Gallieni is Coordinating Editor, The Journal of Vascular Access; Researcher, University of Milano, School of Medicine; and Vice-Director, Renal Unit, San Paolo Hospital, Milan, Italy
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  • Dr. Mauro Pittiruti MD,

    1. Pittiruti is Researcher, Italian National Research Council; and Department of Surgery, Catholic University, Rome, Italy
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  • Dr. Roberto Biffi MD

    1. Biffi is Director, Division of Abdomino-Pelvic Surgery, European Institute of Oncology, Milan, Italy
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Abstract

Adequate vascular access is of paramount importance in oncology patients. It is important in the initial phase of surgical treatment or chemotherapy, as well as in the chronic management of advanced cancer and in the palliative care setting. We present an overview of the available vascular access devices and of the most relevant issues regarding insertion and management of vascular access. Particular emphasis is given to the use of ultrasound guidance as the preferred technique of insertion, which has dramatically decreased insertion-related complications. Vascular access management has considerably improved after the publication of effective guidelines for the appropriate nursing of the vascular device, which has reduced the risk of late complications, such as catheter-related bloodstream infection. However, many areas of clinical practice are still lacking an evidence-based background, such as the choice of the most appropriate vascular access device in each clinical situation, as well as prevention and treatment of thrombosis. We suggest an approach to the choice of the most appropriate vascular access device for the oncology patient, based on the literature available to date.

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