Central Venous Access Devices - The Royal Marsden

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What are the disadvantages of having a central venousaccess device?With any CVAD, there is a risk of infection and a clot formingaround the catheter (thrombosis). If you are at risk of developinga thrombosis you may be given a drug called warfarin (a bloodthinning agent) to reduce the risk of this occurring. There may alsobe times when it is not possible to take blood samples from any ofthe CVADs.What types of CVADs are available?There are three main types of CVADs:• A peripherally inserted central catheter (PICC) (see page 4)• A skin-tunnelled catheter (see page 10)• An implanted port (see page 15).Each of these devices is described in more detail in this booklet.How will I know which device to choose?You may be able to choose from any of the three main types ofCVADs. However, your choice will depend on the type of therapyyou are going to have and your physical condition. Your choice maybe limited, for example, if you have no suitable veins in your arms oryou cannot have a general anaesthetic or you have had lymph nodesremoved during breast surgery. Even if you have no choice aboutthe type of device, you may be able to discuss how and where thedevice will be placed.The table below shows at a glance, the main features of the threedifferent types. More detailed information about each individual typefollows afterwards. However, talk through your choice of device withyour nurse, as there may be variations between different hospitals.2
Central venous access devicesPeripherallyinserted centralcatheter (PICC)Skin-tunnelledcatheterImplanted portDo I have togo to theatreand have ananaesthetic?Will it leaveany scars whenremoved?Can I bath andshower with itin?Will I still haveto have needlesinserted for mytreatment?Can I swimwith it in?NoYesBut only a localanaesthetic andsedationYesYou will needa generalanaestheticNo Yes YesYesBut you can’tsoak your armin the bathYesBut you can’tsubmerge yourchest in the bathYesNo No YesNo No YesDo I need to havethe dressingchanged?YesOnce a weekYesbut only for thefirst three weeksNoDoes it need tobe flushed?YesOnce a weekYesOnce a weekYesOnce a month3
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Central Venous Access Devices - The Royal Marsden

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