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Interventional Radiology

Ports & Central Venous Catheters

People with certain diseases or medical conditions sometimes require that ports be placed into the body so that they can receive medications or nutrients directly into the blood stream or gastrointestinal system, or so blood can be drawn. Central venous catheters (CVC) which is a tube that is inserted directly into the vascular system and is connected to a port. PICC (peripherally inserted central catheter) lines are CVCs that are commonly used for patients who will need treatment for more than a couple of weeks and are placed in the arm. Interventional Radiologists specialize in vascular procedures and have perfected minimally invasive ways to insert ports and CVCs without surgery and accompanying stress and pain for the patient.

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Ports & Central Venous Catheters Information

Ports are recommended for patients who regularly have:

  • Chemotherapy treatments
  • Infusions of antibiotics or other medications
  • Nutritional supplements
  • Hemodialysis
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Procedure Process

What to Expect

You will receive instructions from your doctor who has ordered placement of an access device. You will have blood drawn for pre-procedure testing at either the hospital or your doctor’s office. Staff will tell you if changes in your regular medication routine are needed. You may need to avoid eating or drinking anything for several hours before the procedure. You may receive sedatives during the procedure. Make sure that someone can drive you home.

During Procedure

When discharged, you should rest at home for the rest of the day. You may resume your usual activities the next day, but avoid lifting heavy objects. After having a tunneled catheter or subcutaneous port placed, you should expect some bruising, swelling, and tenderness in the chest, neck, or shoulder, but these symptoms resolve over about 5 days. Pain medicine may help during this time. The small incision will heal in 7 to 10 days. Absorbable sutures are placed, thereby eliminating the need to have the stitches removed.

For the first week, it is especially important to keep the catheter site clean and dry. Some doctors will recommend sponge bathing around the catheter site, then cleaning the area with peroxide, applying an anesthetic ointment that contains an antibiotic, and bandaging the area. It is important to closely follow the instructions given to you about how to care for the incision and the device. You may be told that it is all right to shower after a week, using a piece of plastic wrap over the catheter insertion site, but not to swim.

Call your doctor, nurse, or interventional radiologist if you have any questions about your vascular access device. You must notify them if problems develop with your catheter. Problems needing medical attention include:

  • Fever
  • Redness
  • Warmth
  • Increased swelling or tenderness at the catheter insertion site
  • Fluid drainage from the site

Going Home

When discharged, you should rest at home for the rest of the day. You may resume your usual activities the next day, but avoid lifting heavy objects. After having a tunneled catheter or subcutaneous port placed, you should expect some bruising, swelling, and tenderness in the chest, neck, or shoulder, but these symptoms resolve over about 5 days. Pain medicine may help during this time. The small incision will heal in 7 to 10 days. Absorbable sutures are placed, thereby eliminating the need to have the stitches removed.

For the first week, it is especially important to keep the catheter site clean and dry. Some doctors will recommend sponge bathing around the catheter site, then cleaning the area with peroxide, applying an anesthetic ointment that contains an antibiotic, and bandaging the area. It is important to closely follow the instructions given to you about how to care for the incision and the device. You may be told that it is all right to shower after a week, using a piece of plastic wrap over the catheter insertion site, but not to swim.

Call your doctor, nurse, or interventional radiologist if you have any questions about your vascular access device. You must notify them if problems develop with your catheter. Problems needing medical attention include:

  • Malfunction of the device.
  • Bleeding at the insertion site.
  • Signs of infection such as:
  • Fever
  • Redness
  • Warmth
  • Increased swelling or tenderness at the catheter insertion site
  • Fluid drainage from the site

Frequently Asked Questions

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Why refer to an Interventional Radiologists?

As venous access, they have expert training in opening scarred down veins with either angioplasty or stenting(link). If previously placed central devices fail, Interventional Radiologists can often times salvage the existing device. Ideal placement for any catheter/central device is within the jugular vein rather than the subclavian vein. Placement within the subclavian vein is associated with high long-term thrombosis/stenosis rates, which limits further access sites or possible fistula placement. Jugular placement also involves less risk as there is no real danger of pneumothorax because the needle is never directed toward lung tissue. All long-term ports placed should have a groshong tip, therefore, eliminating the need for heparin flushes. Interventional radiologists can also place PICC’s/Ports that are power injectable, so if a patient would need a CT Scan with intravenous contrast, the central access device can be used to deliver the intravenous contrast.

What types of ports and CVCs are available?

Several types of vascular access devices are available. They differ in the conditions for which they are used, how long they last, ease of use and many other factors. The major types are: tunneled catheters (Hickman or Broviac), peripherally inserted central catheters (also called PICC lines), hemodialysis catheters and implantable ports.

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