Port-a-Cath

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What is a Port-a-Cath?

A Port-a-Cath is a tube (catheter) with a small reservoir (port) attached. It can be used to deliver chemotherapy or other medications into your vein, or to take blood samples for testing.

Port-a-Caths are also called ports, and may be referred to as implantable ports or subcutaneous ports.

The catheter is a thin, soft, flexible tube, usually made of silicone. It is typically tunnelled under the skin of your chest or, occasionally, your arm. One end of the tube enters a large vein just above your heart, while the other connects to the port. The port itself is a small disc, about 2.5–4 cm (1–1.5 in) in diameter, placed under the skin on your upper chest or arm. You will be able to see and feel a small bump where the port sits.

What is a Port-a-Cath
used for?

A port can be used to give treatments such as:

  • Chemotherapy
  • Blood transfusions
  • Antibiotics
  • Intravenous (IV) fluids

Ports can also be used to take blood samples, meaning you won’t need repeated needle sticks in your arms.

You can go home with the port in place. It may remain for weeks, months, or sometimes years. Ports are especially useful if it is difficult to access your veins.

How is a Port-a-Cath
inserted?

The port is usually inserted by a specially trained interventional radiologist in a hospital X-ray suite. The procedure is performed under local anaesthetic, and you can usually go home the same day. You can discuss the position of the port with Dr Goyal beforehand.

A small needle is placed in a vein in your arm or hand, and medicine may be given to help you relax. Local anaesthetic is applied to numb a few small areas on your chest and neck. You may feel some pressure during the procedure, but it should not be painful.

Two small incisions are made:

  1. To create a pocket under the skin for the port (about 3–4 cm long). For chest ports, this is on the upper chest; for arm ports, it is on the inner arm.
  2. A smaller incision in the neck (usually less than 0.5 cm) for the catheter entry into the vein.

The port is inserted under the skin, and the catheter is tunnelled to the smaller incision and placed in the vein. The incisions are then stitched. A small dressing may cover the wounds for a few days.

You may feel sore or bruised for a few days. Simple painkillers such as paracetamol can help.

Important information
After insertion

Monitor the site for redness, swelling, bleeding, bruising, pain, or heat. Contact your hospital, GP, or Dr Goyal immediately if these occur, as they may indicate infection.

Dissolvable stitches are used and will disappear over a few weeks.

Port-a-Cath is usually inserted as a day case procedure which means that you can come in, get the Port-a-Cath inserted and go home the same day.

Blood tests: Before the procedure, you will need to have a blood test to measure full blood count (FBC) and clotting. This will usually be arranged by your doctor or clinic nurse specialist. Dr Goyal’s team can also arrange for these to be done prior to the procedure.

If you are currently receiving chemotherapy, a blood test is needed within one week of the procedure. If you are not currently on chemotherapy a blood test within 8 weeks of the procedure is fine. If you have had a blood test for any other reason within this time we can use the results.

Medications: If you are taking any medicines that thin your blood, such as antiplatelet medicines (for example aspirin or clopidogrel) or anticoagulant medicines (for examples warfarin or rivaroxaban), please Dr Goyal or a team member as you may need to stop them temporarily before your procedure. If you have coronary stents or metal heart valves in place then you should not stop these drugs.

You must not eat or drink for six hours before the procedure. We may need to give you a sedative medicine, which may make you feel sick if you have just eaten.

You must not eat or drink for six hours before the procedure. We may need to give you a sedative medicine, which may make you feel sick if you have just eaten.

You will also need somebody to stay with you overnight.

The port can be used soon after it has been put in. About half an hour before it is used, the skin over the port can be numbed with an anaesthetic cream (EMLA cream).

Just before you have your treatment or blood test, the skin will be cleaned. The nurse will then push a special needle, called a Huber needle, through the skin and into the port. This shouldn’t be painful, but you may feel a pushing sensation. It is very important that the port is only used this special needle as normal needles will damage the port.

Treatment can then be given directly into the bloodstream, or blood samples can be taken. Dr Goyal inserts ‘Power’ ports, which may also be used to administer radiology contrast if you need scan.

If you are having a short treatment, the needle will then be removed. For longer treatments, you will have a dressing placed over the needle to hold it in place until your treatment is finished. The needle is then removed.

After each treatment, a small amount of fluid is flushed into the catheter so it doesn’t get blocked. The port will need to be flushed every four to six weeks if it is not being used regularly.

If you feel able to, the nurses at the hospital will teach you how to do this. They can also teach a partner, relative or friend. A district nurse can also do it for you at home. Your port will not need any other care.

The likelihood of problems with port is low. Most of the problems can be sorted with medication or simple interventions. However, they may require removal and replacement of the port.

Infection: It is possible for an infection to develop inside the catheter or around the port. You should tell your hospital if you have redness, swelling or pain around the port, develop a high temperature (fever), feel faint, shivery, breathless or dizzy.

If an infection develops, you will be given antibiotics. If the infection doesn’t get better, the port may need to be removed.

Blood clots: It is possible for a blood to clot in the vein where the catheter sits. You should contact your hospital doctor or nurse if you notice any swelling, tenderness or redness in the neck or arm on the same side of the body as the port.

If a clot does form, you will be given medication to dissolve it. Your port may have to be removed.

Blocked port: The inside of the catheter can sometimes become partly or completely blocked.

If this happens, it can be difficult to give treatment or to take blood tests through it. The catheter may be flushed with a solution to try to clear the blockage, or the port may need to be removed.

When you don’t need the port any more, it will be taken out. This is usually a much simpler procedure than insertion. A local anaesthetic is used to numb the area.

A small incision is made over the site of the port and the port removed. The catheter is gently pulled out of the vein. The wound is then stitched and covered with a small dressing. You may feel a bit sore and bruised after your port is removed. Simple painkillers such as paracetamol may help with this.

The port shouldn’t interfere with your daily activities. It is best to avoid strenuous exercise for a few weeks after insertion, so your body can heal. Only the Huber needles should be used on your port. Don’t let anyone use any other type of needle.

If the port is in your arm, don’t let anyone take your blood pressure or take blood from a vein in that arm. Don’t lift anything heavier than 15lb (7kg).

You may want to wear a medical ID bracelet saying you have an implanted port. If you need more information, please feel free to contact Dr Goyal.