Implantable Venous Access Port

Why is an implantable venous access port necessary?

Patients with certain medical conditions require long-term intravenous access for administration of medications, chemotherapy, and/or nutritional supplements. The port allows easy repeated access to the bloodstream, causing less vessel damage and discomfort.

What is an implantable venous access port?

The port is a small plastic or metal disc, about 2-3 cm in diameter (the size of a half dollar coin), with a slightly raised rubber injection site called the port septum. Since the septum is raised, it is easily identified from the surface of your skin, making injections quick and easy. The septum is made of a silicone material that reseals itself. The material allows the septum to be punctured many hundreds of times with a special needle and yet retain its integrity.

Attached to the base of the port is a narrow, flexible tube, called a catheter. The catheter is usually inserted into a large blood vessel and delivers your therapy from the port body into your bloodstream.

How is the procedure performed?

Several days prior to the procedure you will be given instructions from the Interventional Radiologist's office staff. You will need to have blood drawn at the hospital or a local clinic for testing. The staff will instruct you on how to prepare for the procedure including modification of your medications if necessary.

Before the procedure, a nurse will start an intravenous line in your arm to give you some medication to help you feel relaxed. You will be sleepy, but you will be awake throughout the procedure. The Interventional Radiologist will inject a local anesthetic in the chest area just beneath the collar bone. During the procedure the Interventional Radiologist will make 2 small incisions. The catheter is placed into the selected blood vessel through one incision and then tunneled under the skin to the other incision site. Here a "pocket" is formed under the skin to hold the port. The catheter is attached to the port and the port is then sutured in place within the pocket. A few stitches are required to close the pocket once the port is in place. An x-ray is then performed to confirm that the catheter is in the proper position in the blood vessel.

After the procedure you will need to recover in the recovery room for one hour. After your discharge from the hospital, you should go home and rest for the remainder of the day. You may resume your normal activities the following day.
The skin overlying the port will be swollen and tender, but this irritation should go away as the incisions heal. The port may be used immediately if necessary, or your doctor may wait until the swelling has decreased. During the first few days after the procedure you should avoid heavy exertion or strenuous activities.

How do I care for my vascular access catheter?

For the first 7 days following the catheter insertion procedure, you should keep the catheter site clean and dry. You may sponge bathe around the catheter site. Clean the area with peroxide and apply betadine ointment and a bandage. After 7 days, you may shower, but you should continue to clean the insertion site with peroxide and apply a bandage to cover the catheter insertion site. "Tegederm" or a small square of plastic kitchen wrap applied over the catheter insertion site is advisable when bathing.

Because the port is implanted completely beneath the skin, it requires minimal care. If permitted by your doctor and subject to his or her instructions, you may bathe, swim, and exercise as you normally would. Once the skin has healed there is no need to cover the port site with a dressing when the port is not in use.

Periodically, the port will need to be flushed to ensure that it remains in working order. Your doctor or nurse will let you know how often this needs to be done and who will perform the flushing procedure. Additionally, you should examine the port site regularly. Once the initial expected swelling and tenderness subsides, you should inform your doctor or nurse if you notice any additional swelling, discoloration, redness, tenderness, pain, or drainage at the incision sites, the needle insertion site, or the port pocket, or if you begin to run a fever or experience any other unusual symptoms.