Portacaths

Portacaths are devices used to deliver intravenous (IV) medications into the bloodstream and to draw blood for laboratory testing.

A portacath, or “port,” is a type of venous access device that provides continuous access to a large blood vessel (vein) in the body. The term comes from a combination of “portal” and “catheter.” The portal refers to a reservoir that is implanted under the skin, usually in the upper chest below the collarbone. The catheter is a soft flexible tube that runs from the portal to a large vein in the body, usually the superior vena cava (SVC). The port sits completely under the skin and feels like and appears as a bump under the skin. To access the port, a narrow needle with is inserted into the port where the bump is, either with or without numbing the skin beforehand.

A portacath can be used to deliver chemotherapy, blood products, antibiotics, and IV fluids directly into the bloodstream. Many chemotherapy agents can only be delivered into a large vein in the body such as the SVC because they could cause severe irritation if delivered to the smaller veins of the arms or legs or lead to a chemical burn if they were to leak into surrounding tissues. Because a port remains in place and delivers medicines directly into the SVC, chemotherapy agents can be safely administered through a port. Ports can also be used to draw blood for testing.

Accessing a large vein such as the SVC without a port is difficult and time-consuming to do on a regular basis; therefore, ports are very useful for cancer patients who require a long period of IV treatment and blood testing.

Because the portacath is entirely internal, the risk of infection is low, and no routine cleaning or dressing is required. Patients are able to remain active without limitations, including swimming. Complications are uncommon and include:

• Clot within the port or catheter: a portacath can develop a clot within it or at its tip, which requires using blood thinners to dissolve the clot. The chance of this type of clotting can be reduced by routinely flushing the port with a small amount of saline and a small amount of a blood thinner every 4 weeks if it is not regularly used.

• Infection: the tissue around the portacath can become infected, requiring antibiotic treatment. Rarely, the portacath will need to be removed if the infection is severe.

• Blood clot: As with any indwelling catheter in the bloodstream, there is a risk of developing a blood clot around the catheter, which requires treatment with blood thinners.

Published Online: December 23, 2015. doi:10.1001/jamaoncol.2015.3488.

Conflict of Interest Disclosures: None reported.