What is a port-a-cath?

A port-a-cath is a type of venous access, that consists of a chamber, or port, and a thin plastic tube (catheter) which are connected to one another. It is inserted in order to provide frequent medication over a long period, such as IV treatment, or take blood on a regular basis.

They are placed under the skin of the chest. The catheter is threaded into a large vein where the treatment is administered or blood is passed through. Medical staff insert a narrow needle into skin over the port site in order to access the port-a-cath. The port allows medication through and then seals itself shut. 

What are the reasons for having a port-a-cath inserted?

If a patient's treatment requires a lot of needles, a port-a-cath can remove the heightened risk of damage to veins because of repeated insertion of needles. This damage can make it difficult for healthcare staff to find veins that are suitable.

Conditions that may require a port-a-cath are:

• Cancer
• Severe infections
• Kidney failure
• Irritable bowel disease (IBD)

Other reasons that a port-a-cath is inserted are:

• Repeated insertion of needles can be uncomfortable for patients.
• They are easy to look after at home. Patients don't need to dress or change them. However, people may need to 'flush' their port-a-cath. This ensures it is clear of clots or blockages, and helps to prevent complications.
• Port-a-caths are durable and can be used for a long time; up to six years.
• They are discreet in appearance in comparison to other medical equipment people may need to take home.

How is a port-a-cath inserted?

Port-a-caths are inserted by a surgeon in a minor procedure. Two cuts, or incisions, are made; one at the top of the collarbone and the other on the front of the chest, where the port-a-cath will be placed. Port-a-cath surgery takes around one hour.

One end of the catheter line will be threaded into the large vein that leads towards the heart. The other end will be tunnelled under the skin into the port. During the procedure, a fluoroscopy (type of X-ray) will be used during the procedure so the surgeon or radiologist can confirm the line is placed correctly.

You will receive pain relief after the procedure and generally, any pain following that will last for four to seven days. This can be managed with over-the-counter painkillers such as paracetamol.

What are the risks involved in port-a-cath insertion?

Potential risks of a port-a-cath insertion can be:

• Infections
• Bleeding or clots

What are the alternatives to a port-a-cath?

A Hickman line, which is like a port-a-cath, is available. It can be accessed without needing a needle, through bungs or ports at the end of the line. The line is placed into the large vein above the heart and it comes out of the chest at an exit site, which is held steady by a small cuff.

You can also consider:

• Peripheral IV lines (PIV) - They are short, last up to four days and may be difficult to use in people with small or weak veins
• PICCs (Peripherally inserted central-line catheter (PICC)) - They are longer than PIVs but need changing every week. Doctors recommend flushing them daily.
• Central venous catheter (CVC) - Similar to PICCs in length and changing frequency.