Port Catheters: Treatment, Effects & Risks

A port catheter (or port) is a permanent access to the arterial or venous circulation or, less commonly, to the abdominal cavity.

What is the port catheter?

Port catheter (or port) refers to a permanent access to the arterial or venous circulation or, less commonly, to the abdominal cavity. A port catheter is a catheter system that is implanted into the subcutaneous fat tissue. The port can be punctured from the outside and provides permanent access to the vascular system. In this way, infusions (for example, blood transfusions, parenteral nutrition, chemotherapeutic agents) can be administered gently and without straining the veins. It is also possible to deliver drugs intravenously with the aid of a port.

Function, effect, and goals

A port catheter includes a chamber with a silicone membrane and a tube that can be connected. The chamber is made of either stainless steel, plastic, ceramic, or titanium. A port catheter is inserted using a surgical procedure, then a cannula is inserted through the membrane to access the bloodstream. A drug or infusion can now be added to the bloodstream through the opening in the cannula. A port catheter is mainly used for the treatment of oncological diseases, and is also used for diseases that require frequent arterial or venous access. Sometimes drugs cannot be administered due to certain anatomical conditions, so the use of a port catheter seems necessary. However, a port can also be used to draw blood or administer blood as well as blood products. Since the port catheter is inserted under the skin, patients can maintain their freedom of movement and carry out their usual activities. Normally, a port lasts up to five years or longer. However, use of the catheter for more than five years should be discussed with the treating physician. Once therapy is completed, the port usually remains in place for another two years, but must be flushed every twelve weeks. It is then removed, with the procedure similar to implantation. The most common technique is access through the cephalic vein. Under local anesthesia, the surgeon makes an incision in the front of the chest wall. From there, he opens the cephalic vein and inserts the catheter. The port chamber is then placed in the subcutaneous fat tissue. Another option is to puncture the subclavian vein or the internal jugular vein and insert the catheter. The port chamber can then be placed near the puncture site. The physician then pulls the catheter through to the skin pocket, with this tunneling providing a barrier to infection. In all techniques, the catheter is checked radiologically, shortened to the desired length, and then connected to the port chamber. The port chamber is then sutured in place and the incision closed. Now infusion solutions or medications can be repeatedly delivered. After implantation, the port is visible as a small bump and can be felt with the fingers. The surrounding area may still be sensitive for a few days, but if the surgical wound heals, the irritation will also disappear. Before removing the stitches, the wound should not come into contact with water. If severe pain, fever or bleeding occurs, it is necessary to contact a doctor. In order for infusions to be administered, the port cannula is punctured. This puncture requires very careful and concentrated work, otherwise complications may occur. The main steps for this are:

  • Provide the necessary materials
  • Disinfection of hands
  • Flat positioning of patients
  • Palpation and disinfection of the puncture site
  • Use of sterile disposable gloves
  • Application of a perforated cloth
  • Use of a sterile port cannula and sterile accessories.
  • Detoxification of the port cannula
  • Fixation of the port housing
  • Insertion of the needle into the membrane
  • Check permeability
  • Sterile dressing

Only special cannulas (for example, Huber needles, Gripper needles) are used to puncture the port, so that the membrane can close again and the administered drugs do not leak. With a port, patients can also play sports and swim.In addition to the venous port, other port systems may be used. These include:

  • Arterial port systems: These are used for regional chemotherapy, and the technique is similar to venous systems.
  • Intrathecal port systems: These are used to deliver analgesics.
  • Peritoneal port systems: This refers to access to the abdominal cavity to administer chemotherapeutic agents.

After insertion, patients usually also receive a port passport with important information for care services or follow-up physicians. In addition, all treatments are noted in a patient diary.

Risks, side effects, and hazards

Possible complications that may occur include thrombosis, hematothorax, pneumothorax, hemorrhage, or infection. The most common complication is systemic infection due to germs or infection of the port. In many cases, the port must then be explanted. In addition, a rupture of the catheter may occur, which is referred to as “pinch-off” in the technical literature. If the catheter is detached in this context, there is a possibility that the catheter fragment will migrate further. Catheters can also become blocked due to deposits on the inner wall or in the port chamber. Infusions with nutritional solutions are one cause of this. Port catheters therefore place very high demands on careful work or hygiene. A port should only be lanced by trained personnel.