Totally Implantable Venous Access Device

What is a port?

A port is a type of totally implantable venous access device and can be used to give medications directly into a vein or to take blood samples. It is designed to remain in place for months or years. It consists of two parts:

Catheter: A thin, hollow tube that lies in a big vein near the heart, and the other end is connected to the hub.

Hub: A small metal chamber that lies underneath the skin and is attached to the catheter. A special needle can be inserted through the skin into the hub in order to give medicines and/or take blood.

The port is usually inserted in the chest wall, known as a
Port-a-Cath, or on the upper arm which is known as a PAS port. More rarely they can be inserted in the groin or abdomen. The location will be discussed with you as part of your referral.

The image below shows the port-a-cath, with the needle accessing the hub.

As the entire port is implanted under the skin, it is usually identified by a bump in the skin. The image below shows a PAS port in the upper arm, before and after being accessed with a needle. The dressing is applied to secure the needle and keep it clean.

What are the advantages of a port?

• No need to find a vein when having intravenous treatment. This can be useful for people with difficult venous access, needle phobias or if you need frequent intravenous access.
• The port is implanted under the skin therefore is not very visible from outside your body.
• It can remain in place for many months or years
• When the needle is not in place you are able to swim, exercise and bathe as usual.
• When the needle is not in place there is no need for any dressing.

How is the port put in?

This is a surgical procedure usually carried out under local anaesthetic with some sedation if you wish. It is not usually recommended to be put to sleep as it is a short procedure and can make your respiratory condition worse.

The catheter is inserted via a small incision in your neck using ultrasound. A further incision is made at the site of the hub and the catheter is tunnelled underneath the skin to meet the hub. The site is then closed using stitches (these are usually absorbable). Most people can go home the same day, your doctors will discuss with you if this is right for you.

Are there any possible complications?

Having a port inserted is generally a safe procedure; however any procedure carries some risks.

• Some tenderness and bruising at the site is common and should settle down after a week or two. You can take paracetamol for pain relief if required.
• Despite best efforts infection can still occur in the wound or the line. Antibiotics would be given to you to treat any suspected infection.
• Thrombosis or a blood clot can form at the tip of the catheter. To prevent this, blood thinning medication will be injected through the line at every use.
• As the port is in connection with a vein there is always the potential for damage to occur to the vein, nearby blood vessels or nerves. To learn more please speak to your medical team.
• A rare complication is a punctured lung, known as a pneumothorax. This is where air leaks out of the lung and becomes trapped between the lung and chest wall. You would need to stay in hospital while this is treated.

How do I take care of my port?

The specialist nurses will teach you about how to care for your port following insertion.

The port will need to be flushed with blood thinning solution every 8-12 weeks to prevent any occlusion. This can be done at hospital or in the community. It is possible for a family member to be trained to flush your port (please speak to your nurse if you wish to explore this option).

When the port is accessed during a course of treatment the needle can remain in place for up to two weeks. After this it must be changed or removed by a member of staff.

If you experience any pain, redness or swelling around your port, or feel unwell following a flush, contact the specialist nursing team for further assessment.

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