A port-a-cath is a device placed semi-permanently under the skin that allows for easy access to the blood vessels (veins). It can be used to draw blood samples, administer medications, or administer contrast for diagnostic imaging tests. Port-a-caths are often used when a patient requires frequent and long-term intravenous therapy, such as chemotherapy for cancer patients. Placement is typically done in the chest by a skilled interventional radiologist. By creating an access site, the patient’s blood vessels are protected from frequent blood draws and chemotherapy medications that can cause blood vessel damage.
Port-a-cath placement is usually done under both ultrasound and fluoroscopic guidance. Ultrasound uses sound waves to locate the vein and guide catheter placement. Fluoroscopy uses real-time X-ray images for guidance, with a small amount iodine-based contrast given in rare instances.
Port-a-cath placement is recommended when there is a need for frequent access to the patient’s blood supply. This could be to:
- Administer chemotherapy or other intravenous medication
- Provide intravenous nutrition (TPN)
- Administer blood transfusions or other blood products
- Allow for repeated blood draws
- Administer contrast for diagnostic imaging studies
Also, some chemotherapy agents are toxic to the smaller blood vessels. Port-a-caths offer access to a larger vein of the body which can tolerate chemotherapy without harm to the blood vessel.
- Port-a-cath placement is minimally invasive and can be performed as a day procedure. This reduces overall risk, complications and recovery time.
- A port-a-cath provides easy access to the blood supply to administer medications or draw blood. This keeps the smaller veins of the arm protected from harm.
- A port-a-cath protects the patient from the discomfort and inconvenience of frequent needle pokes or IV insertion.
- A port-a-cath also protects the patient from infection, which is particularly important in patients with a weakened immune system.
- The procedure can be done under local anesthesia with moderate conscious sedation for patient comfort.
- Only a small incision in the skin is required to place a port-a-cath.
- Port-a-cath placement uses a very small dose of radiation, and the benefit from successful treatment far outweighs the risk. Please see ARA’s information on Radiation Safety.
- There is a very small risk for contrast allergy. If you have had an allergic reaction to contrast material in the past, your radiologist may recommend that you take medication for 24 hours before the procedure to reduce risk.
- While extremely rare, there is a risk of serious allergic reaction to iodinated contrast. ARA radiologists and staff are well prepared in the event of such a reaction.
- Intravenous contrast manufacturers state that mothers should not breastfeed for 1 to 2 days after they receive contrast material. The American College of Radiology (ACR) says that current information suggests that breastfeeding is safe after the use of intravenous contrast. Please discuss your breastfeeding options with your physician.
- Women should always inform the scheduler, physician, and technologist if they are pregnant. It may be necessary to use an alternate exam.
- Patients with diabetes or kidney disease may experience kidney damage from the contrast material. To check for this, a small amount of blood will be drawn before the procedure to check kidney function as well as clotting ability.
- In very rare cases, the catheterization may injure a vessel, which can cause bleeding or vessel blockage. This may require additional procedures to clear the vessel or stop the bleeding.
- Port-a-cath placement is typically done in an ARA imaging center or hospital. The procedure takes about 30 to 45 minutes.
- You may be asked to remove all metal and jewelry, and you will be asked to change into a gown.
- Before the exam, a paramedic or nurse will start an intravenous (IV) line in your arm or hand.
- You will be positioned comfortably on an exam table, and you will be connected to devices that monitor your blood pressure, heart rate, and blood oxygen level. At this point, a dose of sedative may be delivered through the IV to help you relax.
- An area of skin over the chest will be sterilized and covered with a sterile drape. You may be given an injection of local anesthetic. A small incision will be made at the site.
- Using a special needle, a large vein in your upper chest will be accessed. The interventional radiologist will use an ultrasound probe to help locate the vein.
- A series of wires and catheters will be inserted into the vein.
- A special camera (fluoroscope) will take pictures which can be viewed in real time on a monitor by the radiologist. Only if necessary will contrast be injected into the vein to enhance visualization of the blood vessels. For most patients, this is not required.
- Once the catheter is in place, another small incision will be made near the catheter entry site and the port, which is a small metal or plastic disk, will be inserted under your skin.
- A tunnel will be made under your skin to allow for the catheter to connect to the port which is placed under your skin. The port will be tested to make sure blood can be drawn easily.
- More images may be taken to make sure the port-a-cath was placed properly.
- When the procedure is finished, the incisions will be stitched closed.
- You will need to lie flat for about 30 to 45 minutes and may be asked to rest in bed for 2 to 4 hours after the procedure. You may resume your normal activities the following day but should not lift heavy objects.
- If you are sedated for the procedure, you should have someone with you who can drive you home. You should not drive for 24 hours after your procedure.
- Keep the site dry until your post-procedure check, which is usually about a week after the placement. Keep a dressing over the site for the first three days.
- Please let your physician and your scheduler know of all medications you are taking and if you have allergies, especially to iodinated contrast material. Also let your physician and scheduler know about recent illnesses or ongoing medical conditions.
- If you take any blood-thinning medications, aspirin, or products containing aspirin, please contact our office for instructions on discontinuing the medications prior to your procedure.
- You will be asked to remove clothes over the area being examined and to wear a gown. Depending on the exam you may be asked to remove jewelry, glasses, dental appliances or any metal objects that might interfere with the scan.
- Women should always inform the scheduler, referring provider, and technologist if they are pregnant.
- Some doctors recommend that breastfeeding women wait 24 to 48 hours until the contrast clears from their system before breastfeeding again. Before the procedure, breastfeeding women may want to pump breastmilk to have on hand.
- If you will receive sedation for the procedure, you will be instructed not to eat or drink for 6 hours before the procedure. Please discuss this with your ARA scheduler to receive appropriate instructions.
- If you are sedated, please plan to bring a friend or relative to drive you home. You will be kept for observation at the facility until you are cleared to leave and should not plan to drive for 24 hours following the exam.