Name of the Procedure:

Implantable Access Total Catheter, Port/Reservoir
Common name(s): Port-a-Cath, Venous Access Port, Infusion Port
Technical/Medical term: Implantable Venous Access Device (IVAD)

Summary

An Implantable Access Total Catheter, also known as a port, is a medical device placed under the skin. It provides easy, long-term access to a vein for medications, fluids, blood draws, and other therapies, reducing the need for repeated needle sticks.

Purpose

This procedure is commonly performed to provide long-term intravenous access, needed for treatments like chemotherapy, long-term antibiotic therapy, or total parenteral nutrition (TPN). The goal is to ensure convenient, reliable, and pain-free access to the bloodstream.

Indications

• Patients undergoing long-term intravenous therapy (e.g., chemotherapy, antibiotics)
• Those requiring frequent blood draws
• Individuals with difficult venous access
• Conditions warranting continuous or repeated infusions (e.g., hemophilia treatment, pain management)

Preparation

Patients may be instructed to fast for several hours before the procedure. They should also inform their healthcare provider of any medications they are taking, particularly blood thinners. Pre-procedure diagnostic tests might include blood work and imaging studies to assess the vein anatomy.

Procedure Description

1. The patient is given local anesthesia or sedation.
2. A small incision is made to insert the catheter into a major vein (usually in the chest or arm).
3. The port, connected to the catheter, is placed under the skin and secured.
4. The incision is closed with sutures or surgical glue and covered with a sterile dressing.
5. The placement is often verified through imaging, such as X-ray.

Duration

The procedure typically takes 60 to 90 minutes.

Setting

Performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Surgeons or Interventional Radiologists
• Nurses
• Anesthesiologists

Risks and Complications

• Infection at the incision site
• Blood clot formation (thrombosis)
• Catheter malfunction or blockage
• Pneumothorax (air in the chest cavity)
• Allergic reaction to anesthesia or materials used

Benefits

• Reduces the need for repeated needle sticks.
• Provides a reliable access point for long-term treatments.
• Decreases discomfort and anxiety related to frequent venous access.
• Can be used for both infusion treatments and blood draws.

Recovery

Patients typically can go home the same day. Post-procedure instructions include keeping the site clean and dry, monitoring for signs of infection, and attending follow-up appointments for care and maintenance of the port. Most people can resume normal activities within a few days.

Alternatives

• Peripheral IV lines: temporary and less durable.
• Peripherally Inserted Central Catheter (PICC lines): more prone to infection and require more maintenance.
• Hickman/Broviac catheters: external but more prone to infection compared to ports.

Patient Experience

During the procedure, the patient may feel a sting from the local anesthesia but should feel no pain. Post-procedure, mild discomfort or bruising at the incision site is common, but severe pain should be reported to a healthcare provider. Pain management often includes over-the-counter pain relievers, and the port should not cause pain once healed.