TESTS AND PROCEDURES

Vascular Access Port Implantation

October 07, 2017

Vascular Access Port Implantation 

Port implantation is surgery to place (implant) a port under the skin. For vascular access, it is placed into a vein. The port allows medicines or nutrition to be sent right into your bloodstream. Blood can also be taken or given through the port. During the procedure, a long, thin tube called a catheter is threaded into one of your large veins. The tube is then attached to the port. This usually sits under the skin of your chest and causes a small bump. To use the port, a special needle is passed through your skin and into the port. The needle can stay in your skin for up to 7 days, if needed. A port can stay in place for weeks or months or longer.

Outline of man's chest showing heart inside. Port is under skin of upper right chest. Tube from port is inserted into vein leading to heart.

Why is a vascular access port needed?

A vascular access port may allow healthcare providers to give you:

  • Chemotherapy or other cancer-fighting drugs

  • IV treatments, such as antibiotics or nutrition

  • Hemodialysis (for kidney failure)

The port may also be used to draw blood.

Before the procedure

Follow any instructions you are given on how to prepare.

Tell your provider about any medicines you are taking. This includes:

  • All prescription medicines

  • Over-the-counter medicines such as aspirin or ibuprofen

  • Herbs, vitamins, and other supplements

Also be sure your provider knows:

  • If you are pregnant or think you may be pregnant

  • If you are allergic to any medicines or substances, especially local anesthetics or iodine

  • Your full medical history, including why you will need the port

  • If you plan on doing any contact sports

During the procedure

  • Before the procedure, an IV may be put into a vein in your arm or hand. This gives you fluids and medicines. You may be given medicine through the IV to help you relax during the procedure. This is called sedation. But some surgeons place ports using general anesthesia.

  • The chest is used most often for the port. In some cases, your belly (abdomen) or arm will be used instead.

  • The skin over the insertion area is numbed with local anesthetic.

  • Ultrasound or X-rays are used to help the healthcare provider guide the catheter into the proper location during the procedure.

  • A cut (incision) is made in the skin where the port will be placed. A small pocket for the port is formed under the skin.

  • A second small incision is made in the skin near the first incision. A tunnel under the skin is created. The catheter is put through the tunnel and into the blood vessel.

  • The skin is closed over the port. It is held shut with stitches (sutures) or surgical glue or tape. The second small incision is also closed.

  • A chest X-ray may be done to make sure the port is placed properly.

After the procedure

You may be taken to a recovery room where you’ll recover from the sedation. Nurses will check on you as you rest. If you have pain, nurses can give you medicine. If you are not staying in the hospital overnight, you will be sent home a few hours after the procedure is done. A healthcare provider will tell you when you can go home. An adult family member or friend will need to drive you home.

Recovering at home

  • Take pain medicine as directed by your healthcare provider.

  • Take it easy for 24 hours after the procedure. Avoid physical activity and heavy lifting until your healthcare provider says it’s OK.

  • Keep the port clean and dry. Ask when you can shower again. You will need to keep the port dry by covering it when you shower.

  • Care for the insertion site as you are directed.

  • Don’t swim, bathe, or do other activities that cause water to cover the insertion site.

  • To keep the port from getting blocked with blood clots, flush it as often as directed. You should be shown the proper way to flush the port before you go home. It is important to follow these directions.

 

Risks and possible complications of implantation

  • Bleeding

  • Infection of the insertion site

  • Damage to a blood vessel

  • Nerve injury or irritation

  • Collapsed lung (for chest port placements)

  • Skin breakdown over the port

Risks and possible complications of having a port

  • Blocked  port or catheter

  • Leakage or breakage of the port or catheter

  • The port moves out of position

  • Blood clot

  • Skin or bloodstream infection

  • Skin breakdown over the port

 

When to seek medical care

Call your healthcare provider right away if you have any of the following:

  • A fever of 100.4°F (38.0°C) or higher

  • You can't access or use the port properly

  • You can't flush the port or get a blood return

  • The skin near the port is red, warm, swollen, or broken

  • You have shoulder pain on the side where the port is located

  • You feel a heart flutter or racing heart 

  • Swollen arm, if the port is placed in your arm

Updated:  

October 07, 2017

Sources:  

American Society of Anesthesiologists Task Force. Practice Guidelines for Central Venous Access. Anesthesiology (2012); 11693); pp. s539-s573, Complications of Central Venous Catheters and Their Prevention. UpToDate., Hegde HV. The Sheared Central Venous Catheter? Case Reports in Anesthesiology (2011; 279827; 1-4

Reviewed By:  

Image reviewed by StayWell medical illustration team.,Mancini, Mary, MD,Ziegler, Olivia, MS, PA