Central venous access device, or CVAD, is a broad term that includes many types of catheters (thin, flexible hollow tubes) that are inserted into and positioned within a vein in the body to deliver therapies to the bloodstream or withdraw blood for testing. CVADs are used to provide life-saving medications and critical treatment, such as chemotherapy for cancer patients, supplements for patients at risk for malnutrition who cannot receive nutrients via the digestive tract, and antibiotics for patients with severe infections.
An estimated 5 million CVADs are placed each year in the U.S., and this number is increasing as the population ages.
Varying types of CVAD are used for different conditions and therapies. There are two general types of CVADs: catheters and ports. Catheters have one end positioned outside the body, while ports are surgically placed under the skin and require a special needle for access. With both catheters and ports, the opposite end of the tubing is positioned within the large vein near the heart. The most common CVADs include:
Occlusions are a common complication associated with CVADs. It is estimated that 25 percent of all CVADs become occluded and that 60 percent of these occlusions are caused by thrombosis, the formation of a blood clot.
When CVADs become occluded, many complications can occur, including the inability to inject or infuse solutions and/or the inability to withdraw blood.
Occlusions are generally classified as:
While thrombotic occlusions develop over time, mechanical and precipitate occlusions typically form spontaneously.