A portacath (or port) is a special small medical device placed to allow access to the veins. It allows you to have chemotherapy or transfusions without having to undergo repeated conventional vein needle access and without damaging your veins. Ports can also be used to allow vein access in patients who have damaged veins as a result of previous medical treatment.
Why have a portacath inserted?
Ports allow venous access and prevent the need for multiple needles. Your doctor or nurse can use the port to give drugs, chemotherapy or transfusions as well as take blood without putting a needle in your arm. Our ports can also be used to allow x-ray dye (or contrast) to be given again without using an arm needle.
Ports are buried under the skin and therefore have a much lower risk of infection than other forms of vein access.
The placement of ports in central veins also means more toxic medication can be given without damaging the vein.
Is it permanent?
Ports can be left in place for as long as required. At the end of a treatment plan, a port can be removed using a minor procedure under sedation and local anaesthetic. If required they can be left in place and function well and safely for many years. If not used then a regular flush of saline is required to prevent the port from blocking.
How is it placed?
The procedure is performed by a specialist interventional radiologist – an expert in this area. A small plastic tube (<3mm) is placed in a vein at the bottom of the neck. This is connected to a metal port placed under the skin on your upper chest. The port can usually be felt under the skin. When placed by an interventional radiologist, this is a minimally invasive procedure. An incision about 5 cm long is needed to place the port.
Ports are placed under local anaesthetic and sedation. The procedure usually takes 30-45 minutes.
You will go home later that day once you have adequately recovered from the sedation. You will not be able to drive yourself home.
Ports can also be placed surgically but ports placed this way carry higher risks from insertion and malfunction more commonly.
How does it work?
A special needle is used to access the port through the skin on the chest. This can be done following the use of local anaesthetic cream to numb the skin. The port has a rubber drum which seals once the needle is removed, allowing the port to be used over and over without a problem.
What about cosmetics?
The pocket under the skin in which the port is placed is closed with absorbable sutures and sometimes special skin glue. Once the skin is healed the port will be much less visible. Depending on how thin you are you may notice the port or the tubing. As a port is buried you can carry on with your normal activities, including sport and swimming without worrying about the port moving or breaking.
What are the risks?
This a minimally invasive procedure and risks or complications are very unlikely.
- Infection – as the port requires a skin incision there is a small risk of skin infection, this is minimised by dressing the wound until healed. The port should only be accessed to reduce the risk of introducing infection. If a port infection develops then, unfortunately, it will usually have to be removed.
Usually, your specialist will have referred you for port placement. We are happy to see you in the Interventional Radiology clinic prior to the port placement procedure.
Usually none. It is useful to know if you have had any previous vascular access procedures or ‘lines’ in your neck veins. Any prior or planned chemotherapy using Avastin is also important as this can affect wound healing.
Under an hour.
No, we insert ports under local anaesthetic and sedation.
You will stay a few hours until the sedation has fully worn off.
There are no major side effects. You may have minimal discomfort for a few days. You will have to keep the wound clean and dry for a week until healed. You can return to non-physical work and non-strenuous activities prior to this.