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800px-PAC_met_Gripper_erin

Definition:

  • A small medical appliance that is installed beneath the skin
  • A catheter connects the port to a vein
  • Under the skin, the port has a septum through which drugs can be injected & blood samples can be drawn many times, usually with less discomfort for the patient than a more typical “needle stick”
  • Used mostly to treat
    • Haematology & oncology patients
    • Haemodialysis patients
  • Usually inserted in the upper chest, just below the clavicle, leaving he patient’s hands free
  • The main form of a implantable central venous catheter or line

Terminology:

  • A portmanteau of “portal” & “cathether”
  • Port-a-Cath is a registered trade mark of Smiths Medical
  • The term totally implantable venous access system (TIVAS) is also used

How it works:

  • The catheter runs from the portal and is surgically inserted into a vein (usually the jugular vein, subclavian vein, or superior vena cava).
    • Ideally, the catheter terminates in the SVC, just upstream of the right atrium. This position allows infused agents to be spread throughout the body quickly & efficiently

Gray576

Risks:

  1. Infection
  2. Thrombosis – to prevent clotting the portacath is flushed with saline & heparin
  3. Mechanical failure
  4. Age
  5. Pneumothorax
  6. Arterial injury

Portkatheter_Röntgen

NB:

CVC can be divided into 

  1. Peripherally inserted central catheters (PICC)
  2. Non-tunnelled CVCs
    1. Used in ICU or ED for emergent or short term access  (<7~10 days)
    2. Vascath used for haemodialysis
  3. Tunnelled CVCs
    1. Hickman’s catheters, permacath
  4. Implantable ports
    1. e.g. Port-a-Cath, Infus-a-Port
    2. May be located in the chest or arm (brachial)
    3. May be single or dual lumen