What is a port-a-cath system?
A 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. A 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:
- Port: a small sealed reservoir compartment with a covering made of silicone
- Catheter: a thin flexible tube
- Catheter connector: connects the catheter to the port
What are the indications of a port-a-cath system?
A port-a-cath is indicated for treatments that require long-term access to veins for the administration of:
- Parenteral nutrition (IV nutrition)
- Frequent transfusions of blood (or blood products)
- Pain management
How is a port-a-cath system placed?
The port-a-cath placement requires a minor surgical procedure that takes less than an hour and is often performed under local anesthesia 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 anytime 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 anesthetic 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.
Are there any complications with the placement of the port-a-cath system?
Great measures are taken throughout the procedure to avoid any complications. However, rarely complications may occur that may include, but are not limited to:
- Bleeding caused by injury to the blood vessels
- Severe infection at the incision site or within the bloodstream that may require the removal of the device
- Formation of blood clots in the catheter
- Air getting into the veins (known as an air embolus)
- Injury to the lung while accessing the large vein above the heart
- Injury to an artery, that occurs when the catheter enters an artery instead of a vein
- Breakage of the port-a-cath system, which occurs very rarely. The broken piece may migrate to another site, requiring surgical measures to remove it.
How do you care for your port-a-cath system?
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.
- Flushing the implanted port with heparin solution between each use, and every 4 weeks when not in use, to prevent blood clots and blockages in the catheter should be done by a licensed professional.
- 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 well taken care of, it can remain in place for the entire duration of the therapy.
What are the advantages of a port-a-cath system?
The implanted port-a-cath has the following benefits:
- Involves less pain and discomfort when undergoing treatments
- Eliminates the need for multiple needle pricks in the vein to draw blood or infuse medication or fluids.
- Eliminates pain and reduces the time spent trying to access a suitable vein
- Since the system is placed in a large vein, medicine gets diluted causing 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.
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