PORT-A-CATH® Implantable Venous Access System
The PORT-A-CATH® Implantable Venous Access System, manufactured by Smiths Medical, is designed to make accessing a patient's bloodstream a simple and efficient process. The system includes an implantable portal that is surgically inserted under the skin. A catheter is then connected to the portal and run into a vein, allowing for repeated bloodstream access. The PORT-A-CATH system is used to administer medications, fluids and nutritional solutions, and to enable blood to be drawn. It is designed to stay in place for an extended period, but may be surgically removed whenever necessary.
The PORT-A-CATH system comprises three parts: the portal, which is similar to a reservoir; the catheter, a thin, flexible tube; and the catheter connector, which connects the portal and catheter. The portal is implanted under the skin, usually in the upper-right-chest area. The catheter is typically inserted into a major vein in the middle of the chest. The area of the portal into which the medication-carrying needle will be inserted is made of self-sealing silicone rubber that can be punctured hundreds of times before it wears out. The PORT-A-CATH system eliminates many of the complications associated with repeated IV insertion.
Other manufacturers have developed implantable venous access systems under brand names that include Bardport, Clip-a-Port, Eco Port, Infuse-a-Port, Lifesite, Medi-Port, Microport, Passport, PowerPort and SmartPort.
Placement of the PORT-A-CATH System
Inserting the PORT-A-CATH portal and catheter is considered a minor surgical procedure. Performed in less than hour, it requires only local anesthesia. Typically, a small incision is made in the chest wall to create a pocket for the port, which is placed completely inside the body. A slightly larger incision is made in the lower portion of the neck to access the vein into which the catheter will be inserted. Imaging guidance from ultrasound or X-rays is used for inserting the catheter. Once inserted in the vein, located at a point above the heart, the other end of the catheter is attached to the port. Absorbable sutures are used to close the incision in the chest; the neck incision requires only sticky medical tape to close it. Patients can usually go home within two hours after the procedure has been completed, or after the sedation has worn off. A driver is required because the patient may not operate any type of machinery until 24 hours have passed. After the incisions have healed, there may be a small bump under the skin from the port.
There are occasions when the portal and catheter are placed in the upper or lower arm, again with the end of the catheter placed in the vein at a point just above the heart.
Removing the PORT-A-CATH system is the reverse of its placement, with the same incisions being used.
Uses of the PORT-A-CATH System
There are many situations in which the PORT-A-CATH system may be used, including for the administration of:
- Chemotherapy drugs
- Antibiotic or antiviral treatments
- Blood products
- Hemodialysis
- Anticoagulants
- Multiple blood tests
- Nutritional products
Benefits of the PORT-A-CATH System
Using a PORT-A-CATH system has a number of benefits compared to repeated IV-line insertion. They may include:
- Less vein, muscle and skin-tissue damage because medication dilutes faster
- Single location for injecting medicine or taking blood samples
- Elimination of need to find new veins for each injection or when taking a blood sample
- Buildup of scar tissue at the portal location, reducing pain from needle injection
- Extended chemotherapy or other treatment sessions (needle is left in port)
- Simultaneous infusion of different chemotherapy drugs/treatments (double port is used)
- Less pain for patients who require intravenous feeding
- Less scarring from needle injections
Risks Associated with the PORT-A-CATH System
There are a number of risks associated with using the PORT-A-CATH system, but most doctors and patients believe that the benefits outweigh them. Potential risks may include:
- Infection
- Bleeding in the area near catheter insertion
- Clotting in the vein that contains the catheter
- Blood-vessel injury from prolonged use
- Clogging of the catheter with coagulated blood
- Kinking or twisting of the portal or the catheter
Indications that an infection has developed or that the catheter has shifted position include insertion-site burning, stinging and pain. Swelling or the feeling of fluid under the skin are also indications that the catheter may have shifted.