Portacath Insertion & Removal
Port-A-Cath, also called an implanted port or implantable venous access system, is a small medical device that is implanted beneath the skin in the chest or arm to allow easy access to the bloodstream when you require frequent or continuous administration of medicine. Port-A-Cath is used for drawing blood, infusing drugs (example: chemotherapy) and nutrients, and also for blood transfusions.
The Port-A-Cath system has three parts:
- The portal –a small sealed reservoir compartment with a septum made of silicone
- The catheter – a thin flexible tube
- The catheter connector – connects catheter to the portal
Port-A-Cath placement requires a minor surgical procedure that takes less than an hour and is performed under local anaesthesia or with sedation. Your doctor will make an incision in the chest or arm to place the port completely under the skin. One end of the catheter is attached to the port and the other is inserted into a large vein in the chest or arm (based on the port placement) and the tip of the catheter is threaded into the large vein (subclavian vein or jugular vein) just above the heart, near your neck. Once the system is in place, you can see or feel a small bump in your chest or arm from the portal.
Once implanted, the Port-A-Cath can be accessed to deliver drugs or draw blood samples by inserting a special needle through your skin into the silicone septum of the port. Your doctor may apply an anaesthetic cream to numb the region of the needle prick. For drug delivery, the medication is injected through a needle or IV into the portal reservoir, and is slowly released through the catheter into the bloodstream.
Risks and Complications
Great measures are taken throughout the procedure to avoid any complication. However, rare complications may occur that include:
- Bleeding caused by injury to the blood vessels
- Severe infection at the incision site or within the bloodstream that may require removal of the device
- Formation of blood clots in the catheter
- Injury to the lung while accessing the large vein above the heart
- Injury to an artery, that occurs accidentally when the catheter enters the artery instead of a vein
- Breakage of the Port-A-cath system, that occurs very rarely. The broken piece may migrate to another site requiring surgical measures to remove it.
Caring for your Port-A-Cath
Once the system has been implanted under your skin you will be instructed on ways to take care of the port and precautions you need to follow. The following are some general guidelines:
- The port-a-cath site should be kept clean and dry at all times. When the access needle is in the port, a dressing will cover the needle that needs to be kept clean and dry. If you do not have a needle in the port, you can shower normally.
- Inspect your port regularly. If you have redness, tenderness or swelling after 24-48 hours of port insertion or any leakage from the site, contact your doctor immediately.
- Avoid strenuous activities for at least 10 days, especially those involving the chest or the arm depending on the placement of port.
- Flush the implanted port between each use, and every 4 weeks when not in use, with heparin solution to prevent blood clots and blockages in the catheter.
- Minimize activities like swimming, golfing or weight-lifting to prevent damage or fragmentation of the catheter. Do consult your doctor before engaging in such activities.
When the system is looked after well, it can remain in place for the entire duration of the therapy.
Advantages of Port-A-Cath
The implanted Port-A-Cath has the following benefits:
- Less pain and discomfort when undergoing treatments
- Eliminates the need for multiple needle sticks in the vein to draw blood or infuse medication or fluids
- Eliminates the pain and reduces the time spent trying to access a suitable vein
- Since the system is placed in a large vein, medicine gets diluted, so causes less damage to the surrounding tissues, and spreads throughout the body quickly and efficiently when compared to conventional administration through a smaller vein.
- More than one type of medication or other treatment can be given at the same time using a double port system.