Administration of cancer chemotherapeutic drugs through the enhanced peripheral veins by creating a radiocephalic fistula

Abstract

Background: Administration of chemotherapy through peripheral veins is a morbid procedure. The alternatives include implantable venous ports with associated cost and complication of buried foreign body. Methods: In this pilot study, we created an arteriovenous fistula (AVF) at the wrist of cancer patients due for chemotherapy and then used the resultant enhancement of the peripheral veins of the hand and forearm for administering chemotherapy. The complications of this novel method are compared with our historical controls receiving chemotherapy through the peripheral veins without AVF. Results and Conclusions: Ten patients were offered this new technique after prior informed consent and were followed prospectively for 1 year. Venous accessibility was excellent in the experimental arm with no incident of erythema, thrombophlebitis, or skin necrosis. No significant alteration was found in cardiac parameters at 1, 6, and 12 months post AVF surgery. The procedure proved economical and affordable for a majority of our patients. © 2007 Excerpta Medica Inc. All rights reserved.