PortACath

Port-a-cath, short for port-a-catheter, is a type of implantable venous access device (IVAD) designed for repeated, long-term administration of medications and for frequent blood sampling. It consists of a small, usually titanium or silicone reservoir implanted under the skin, commonly in the chest wall, connected to a catheter that enters a central vein, typically the superior vena cava with the catheter tip at the cavoatrial junction.

Access is gained by puncturing the skin over the reservoir with a specialized non-coring needle called a Huber needle. The skin is sterilized; the port is accessed to deliver chemotherapy, antibiotics, nutrition, or draw blood. The reservoir is sealed between uses to prevent air entry.

Implantation is a minor surgical procedure performed under local anesthesia with light sedation or general anesthesia. The surgeon creates a subcutaneous pocket for the reservoir and routes the catheter through a central vein. After therapy ends, the device can be surgically removed.

Indications include long-term chemotherapy, frequent IV antibiotic therapy, total parenteral nutrition, and long-term venous access when repeated peripheral cannulation is impractical. Benefits include reduced needle sticks, freedom from external catheters, and continued venous access during showering and activity.

Maintenance involves regular flushing with saline, with or without heparin, to prevent occlusion and infection. Access devices must be kept sterile; signs of infection include redness, pain, swelling, fever, or discharge. Complications can include infection, catheter thrombosis or occlusion, fracture or dislodgement, pneumothorax during placement, malposition, skin erosion, or port extrusion.

Durability varies; many ports remain functional for years and are removed when no longer needed. Regular follow-up and prompt attention to problems are essential.