CAVA RCT sets stage for pivot to PORTs as central venous access devices of choice


The CAVA (Central venous access devices for the delivery of systemic anticancer therapy) randomised controlled trial (RCT), just published in The Lancet, has revealed that totally implanted ports (PORTs) are more effective and safer than both Hickman-type tunnelled catheters and peripherally inserted central catheters (PICCs). These findings provide important high-quality evidence from more than 1,000 patients to steer choice. Currently, PICCs are by far a dominant strategy in the West, and PORTs the least frequently used of the three devices. “Decision-making processes behind the choice of device are poorly understood globally,” the authors report, but the ease with which PICCs are inserted by nurse-led teams may favour their regular use.

Jonathan G Moss (Institute of Cardiovascular and Medical Sciences, Glasgow, UK), chief investigator of the National Institute of Health Research- (NIHR-) funded trial, tells Interventional News that despite the higher upfront costs associated with PORTs and the fact that they are relatively more difficult to place, most patients receiving systemic anticancer treatment for solid tumours for more than three months should receive a PORT within the UK National Health Service.

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