The five-year experience by one surgical team of the implantation of 419 chronic venous access catheters in 368 adults and children is reported. The majority of the catheters were required for the management of malignant disease but some were used for long-term home parenteral nutrition. The inferior vena cava was cannulated through the long saphenous vein in 181 cases and the superior vena cava by the jugular or cephalic veins in 238. Mean catheter lives of over one year, with individual lives of more than three years were achieved by both routes. The overall infection rate was 18%. No excess of thrombotic or infective complications was observed in patients with long saphenous vein catheters. It is suggested that the long saphenous vein is an appropriate route for chronic venous access for chemotherapy in most patients.
