Two Broviac catheters for intensive long term support of patients with cancer.

Two Broviac catheters were placed simultaneously in 93 patients who required prolonged intravenous support while receiving chemotherapy or a bone marrow transplant. The technique involved two venotomies in a single vein and was performed under local anesthesia in the operating room. Pancytopenia was not considered a contraindication. Blood sampling and intensive treatment with blood products, chemotherapy, parenteral nutrition and multiple antibiotics were facilitated by these durable, well-tolerated Silastic catheters. Patients were taught to care for them following discharge, and the majority of catheters were used for outpatient treatment. The few complications encountered were compensated for by the convenience and safety of the double Broviac method. The danger of chemotherapy extravasation was completely obviated, as were the complications of repeated central line insertion, and the anxiety and pain associated with multiple unsuccessful attempts at venipuncture. Because of the enthusiastic acceptance of long term Silastic catheters by patients and nursing staff, we regard this technique was a step forward in solving the problem of difficult vascular access in cancer patients.