After a learning curve of 18 months, the feasibility of the integrated treatment increased to greater than 90%, and mortality dramatically decreased. The combined treatment resulted in a high survival rate in patients with extensive carcinomatosis who were no longer responsive to traditional therapies.

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This case illustrates how an early diagnosis and prompt antibiotic therapy can determine a more favorable outcome.

Cutaneous microbial flora has a primary role in CRBI development within TIVADs; there is a relationship between cutaneous colonization and CRBI; colonization reaches its maximum during the first days after catheterization in which the use of the system is at high risk; colonization occurs both via extraluminal and endoluminal routes; there is no difference in CRBI incidence between bolus and continuous infusion administration.

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We report a case of a cancer patient who displayed a persistent left superior vena cava (PLSVC) after implantation of a central venous catheter (Port-a-Cath), as revealed by angiography. This anomaly is rather rare (0.3% of healthy individuals), and the few studies on the long-term maintenance of an implant in situ are not very informative. Nevertheless, based on the acceptable venous caliber and the patient's serious clinical situation, we decided to leave the catheter in place and perform infusional chemotherapy and supportive therapy with careful and continuous control. The patient died after 8 months of this therapy. No complications attributable to the catheter were observed. We think that the risk is acceptable in similar conditions.

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