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Prolonged central venous access for outpatient chemotherapy was achieved in 74 patients utilizing a totally implantable access disc system. The system consists of a stainless steel drug reservoir implanted in the subcutaneous tissue of the anterior chest wall. The reservoir is attached to a Silastic catheter which is then tunneled to a central vein and positioned in the superior vena cava. In 6,762 patient days of observation, there was a high degree of patient acceptance and a low incidence of complications. There were four instances of thrombosis and two of catheter-related sepsis among 17 complications. Seven access discs required removal. The implantable nature of this system offers an attractive alternative to other available methods of prolonged central venous access.

Two patients with hormone-secreting metastatic tumors of the liver (carcinoid, islet cell) were treated with transcatheter arterial embolization. In both cases, occlusion of blood supply to the tumors Was accomplished, resulting in cessation of the systemic symptoms. Arterial embolization provides another useful palliative therapy for hormone-secreting tumors of the liver.