Port-a-Cath The Phlebology Clinic / Services / Port-a-Cath Introduction Key information Description of treatment Venoplasty Venous stenting What is a Vascular Access Port? Port-a-Cath (A vascular access port, port-a-cath, or intravenous port) is a small medical device implanted subcutaneously that provides permanent and reliable access to the venous system. long-term and secure access to the venous systemThe system consists of a reservoir (port body) made of titanium or plastic, sealed with a silicone septum, and a thin catheter inserted into a large central vein (most commonly the internal jugular vein or the subclavian vein). Port-a-Cath (also known as port-a-cath or a totally implantable venous access device) is an advanced medical device implanted subcutaneously, providing permanent and secure access to the patient's bloodstream. The placement of a vascular port ensures that patients requiring constant, repeated intravenous injections can utilize the vascular port access comfortably. Name port-a-cath stems from the very design of the device. Port (English. portal) means a gate, entrance, or access point. In this context, the role of the gate is served by a titanium or plastic reservoir with a silicone septum, which acts as the "entry point" into the system. Cath (Eng. catheter) is a term for a thin tube that delivers medication from the reservoir directly into a major venous trunk. A vascular access port enables the repeated administration of medications—including chemotherapeutic agents, antibiotics, or parenteral nutrition—without the need for recurrent peripheral vein punctures. This solution is particularly valuable for patients requiring long-term oncological treatment, for whom peripheral venous access is difficult or who prioritize comfort and the safety of their therapy. Why is it worth having a vascular access port implanted at the Phlebology Clinic? Clinic of Phlebology in Warsaw offers comprehensive care during vascular port implantation. We combine the expertise of specialists with modern diagnostic facilities: an experienced medical team – procedures are performed by Małgorzata Misiak, MD, PhD, a specialist in anesthesiology and intensive care with many years of experience in establishing vascular access; anesthesia is selected individually to the Patient's needs – the type of anesthesia is adjusted to the Patient's preferences and requirements, ensuring maximum comfort during the vascular port implantation procedure; dual imaging control – the position of the vascular catheter is verified using both ultrasound (USG)both in the treatment of and radiography (X-ray), which minimizes the risk of complications; on-site access to specialists – if necessary, we provide consultations with a radiologist, interventional radiologist, and vascular surgeon; comfortable recovery – after the procedure, the Patient stays in a private recovery room under the care of qualified nursing staff. Thanks to this approach, the vascular port implantation at the Phlebology Clinic is safe, precise, and comfortable for the Patient. Indications for vascular port implantation Who is recommended for a vascular port implantation? Vascular port implantation is primarily indicated for Patients requiring long-term or repeated intravenous access: Oncological indications: systemic chemotherapy immunotherapy and targeted therapies supportive care (antiemetics, hydration) Non-oncological indications: long-term intravenous antibiotic therapy (e.g., for endocarditis, osteomyelitis, cystic fibrosis) total parenteral nutrition (TPN) regular transfusion of blood products (e.g., for individuals with hemophilia) chronic pain therapy difficult peripheral venous access (especially in patients after multiple cycles of chemotherapy or obese patients) immunotherapy and targeted therapies supportive care (antiemetics, hydration) Phlebological indications: damaged or post-thrombotically altered peripheral veins following previous intravenous therapies recurrent superficial thrombophlebitis after peripheral cannulation the need to protect veins from chemical damage Benefits of having a vascular access port damaged or post-thrombotically altered peripheral veins following previous intravenous therapies recurrent superficial thrombophlebitis after peripheral cannulation the need to protect veins from chemical damage Key information regarding vascular port implantation Type of anaesthesia local with sedation (optional short-term intravenous anesthesia). Duration of treatment 30-45 minutes Miejsce poddawane leczeniu Central veins in the upper chest or neck Risk of complications low (infection, hematoma, port displacement <5%) Physical activity quick return to daily activities Recovery 1-2 days (return to activity after 24-48h, avoiding physical exertion for one week). Preparation for the vascular port implantation procedure Required medical tests before the procedure Blood type Complete Blood Count (CBC) with differential Coagulation profile Biochemical tests Pre-operative recommendations Discontinuation of anticoagulants – according to the attending physician's instructions (usually 5–7 days before the procedure for warfarin and oral antiplatelet drugs, 3 days for acenocoumarol, and 24–48 hours for low-molecular-weight heparins or non-vitamin K antagonist oral anticoagulants (NOACs)). Reporting all medications – especially aspirin, clopidogrel, and other antiplatelet drugs that affect blood clotting. Fasting requirement – no food or drink for at least 6 hours before the procedure (in cases where sedation is used). Personal hygiene – bathing before the procedure, ensuring clean skin in the subclavicular area, and removal of chest hair. Pre-operative consultation If necessary, during the qualifying visit, the anesthesiologist: Assess the patient's general health Analyze the test results Discuss the procedure and potential post-operative complications Select the optimal site for port implantation Answer the patient's questions Did you know? A vascular access port for chemotherapy has one major advantage that is particularly appreciated by our oncology patients. Once implanted, it is completely hidden under the skin and practically invisible. After the implantation site has healed, which usually takes 10–14 days, a patient with a vascular port can return to full daily activity: bathing, swimming, and even moderate physical exertion. I always emphasize that a chemotherapy port does not restrict normal functioning – only very intensive activities, such as heavy weightlifting or extreme sports, require caution during the first weeks after the procedure. by Małgorzata Misiak, MD, PhD, specjalistka anestezjologii i intensywnej terapii, Klinika Flebologii w Warszawie Price range Porty naczyniowe konsultacja anestezjologiczna przed zabiegiem założenia portu naczyniowego PLN 400 Make an appointment założenie portu naczyniowego PLN 6000 Make an appointment konsultacja pozabiegowa wczesna (do 3 miesięcy od założenia portu naczyniowego) 250 zł Make an appointment konsultacja pozabiegowa odległa (powyżej 3 miesięcy od założenia portu naczyniowego) PLN 350 Make an appointment Description of the vascular port implantation procedure (1) Patient preparation for vascular port implantation: The patient is placed on their back with their head slightly tilted back. The next step is thorough skin disinfection in the subclavicular area or on the neck. Application of a sterile drape over the surgical field. Administration of local anesthesia (or sedation – according to medical indications and the patient's preferences). (2) Obtaining vascular access: Puncture of the internal jugular vein (or less commonly the subclavian or common femoral vein) under ultrasound guidance. Insertion of a guidewire through the access needle. Verification of the position of the intravenously placed guidewire. (3) Creating the pocket for the vascular port: After anesthesia is administered, a small skin incision is made (pocket length of 2–3 cm) just below the collarbone. Dissection of the subcutaneous pocket for the port chamber. Careful hemostasis (stopping local bleeding). (4) Implantacja (wszczepienie) systemu „port-a-cath”: Tunneling of the catheter from the venous puncture site to the port pocket. Connecting the catheter to the port chamber. Placing the port chamber in the previously prepared pocket. Verifying the patency (flow) of the implanted system. Visualization of the vascular port placement. The illustration shows the subcutaneous port chamber connected to a catheter inserted into the superior vena cava. This is a safe and long-term solution that ensures permanent access to the venous system. (5) Radiographic control after vascular port placement: po założeniu portu naczyniowego: Intraoperative X-ray or ultrasound guidance lub USG – confirming the correct position of the catheter tip in the superior vena cava. Exclusion of potential complications, such as pneumothorax. (6) Closing the dissection site: Placement of individual sutures at the dissection site. Application of a sterile dressing. Providing instructions on post-operative wound care. Duration of the entire procedure: 20-45 minutes 20-45 minut Contraindications for vascular port implantation: Absolute contraindications: Active systemic infection (sepsis) Infection of the skin or soft tissues at the planned implantation site Severe coagulation disorders that do not respond to simple correction Known allergy to the materials from which the vascular port is made Relative contraindications: Neutropenia (low neutrophil count in the complete blood count) – consideration of delaying the procedure. Significant thrombocytopenia (low platelet count). Deep vein thrombosis in the planned implantation area. Previous radiotherapy in the subclavicular area. Anatomical abnormalities in the structure of the central veins. In each case, the decision regarding qualification for the procedure is made by the attending physician after an individual assessment of the Patient. Possible complications associated with the vascular port implantation procedure: Early complications (intraoperative and perioperative): Rare (but possible): Pneumothorax – accumulation of air in the pleural cavity (risk <1% when using ultrasound-guided vein puncture). Hematoma at the implantation site – usually small and resolves spontaneously. Bleeding from the puncture site. Cardiac arrhythmias – transient, associated with endocardial irritation by the guidewire. Arterial injury (very rare under ultrasound guidance). Air embolism (an exceptionally rare complication when proper technique is followed). Late complications: Rare (but possible): Port infection – requires antibiotic treatment; sometimes requires permanent removal of the port. Venous thrombosis associated with the presence of the catheter within the vein lumen Catheter displacement or damage. Skin erosion over the port (occurs in very thin Patients). The risk of complications is minimized thanks to: dzięki: The extensive experience of the specialist physician performing the procedure Controlled puncture techniques using ultrasound (USG) and low-dose X-ray (RTG) equipment. Strict adherence to aseptic principles Proper post-operative care of the surgical area. Vascular port implantation procedures at the Klinika Flebologii (Clinic of Phlebology) are characterized by a high level of safety. This is due to the extensive experience of the medical personnel. Post-operative care after vascular port implantation: Immediately after port implantation: Observation at the Clinic: – The Patient stays in a private observation room under nursing care. This stay usually lasts up to 1 hour to ensure the patient feels well before leaving. X-ray Control (RTG) – Standard procedure involves performing an X-ray immediately after the surgery Dressing: – A sterile dressing is applied and should remain in place for 24–48 hours Pain Management: – If needed, standard over-the-counter painkillers (such as paracetamol or ibuprofen) are usually sufficient to manage any local soreness. Recommendations for the first few days Wound Care Keep the dressing dry for the first 48 hours following the procedure. Change the dressing every 2–3 days, or sooner if it becomes visibly soiled or loose. Disinfect the wound area strictly according to your doctor’s instructions. Suture removal typically takes place after 10–14 days. Restrictions for the first few days Avoid lifting heavy objects (>5 kg) for 7–10 days after the procedure. Stop intense physical exercise involving the arm on the side of the port for 2 weeks. Refrain from bathing in a tub or swimming in a pool until the wound is fully healed. Quick showers are allowed 48 hours after the procedure, provided the dressing is carefully protected from getting wet. Warning signs requiring contact with the Clinic Fever above 38°C. Increasing pain, redness, or swelling around the port implantation site. Discharge (blood-stained or pus) leaking from the wound. Shortness of breath or sudden chest pain. Increasing swelling of the arm or neck on the side where the port was placed. Long-term vascular port care Flushing the port – if the port is not being used regularly, it must be flushed every 3 to 6 months Using Huber needles only – these are specialized non-coring needles designed to penetrate the silicone septum without damaging or "coring" the material. Regular check-ups – schedule periodic follow-up visits according to your physician's specific recommendations. Port Identification Card – the Patient receives a dedicated card containing technical details about the implant. This should always be carried with you. How to properly care for a vascular port after implantation? Proper care of a vascular port is crucial for its long-term and trouble-free functioning in daily life. Here are the most important rules that every patient with a chemotherapy port should follow: Wound care in the first days after the procedure During the first 48 hours, the dressing should remain dry and intact. After this time, it should be changed every 2–3 days, disinfecting the skin around the wound with an antiseptic (e.g., Octenisept, Skinsept) each time. Avoid soaking the wound until the sutures are removed (10–14 days after). A short shower is allowed, but the implantation site should be protected with a waterproof patch. Codzienne obserwacja portu naczyniowego Po wygojeniu rany regularnie kontroluj okolicę portu naczyniowego. Dbaj o dobry stan skóry nad komorą portu poprzez jej odpowiednie natłuszczanie i i odżywianie. Zwracaj uwagę na ewentualne zaczerwienienie, obrzęk, ból lub wyciek – mogą świadczyć o infekcji. Skóra nad portem powinna być gładka, niebolesna i mieć naturalny kolor. Jeśli zauważysz niepokojące zmiany, skontaktuj się z Kliniką. Regularne przepłukiwanie to fundament sprawnie działającego portu naczyniowego Nawet jeśli port naczyniowy nie jest aktualnie używany do podawania leków, wymaga on regularnego przepłukiwania. Zalecany odstęp to 3-6 miesięcy. Przepłukiwanie wykonuje pielęgniarka lub lekarz przy użyciu specjalnej igły Hubera, która nie uszkadza silikonowej membrany. Zaniedbanie tej czynności może prowadzić do zatkania portu i konieczności jego wymiany. Higiena i aktywność fizyczna Po pełnym wygojeniu (około 2-3 tygodnie od wykonania zabiegu) możesz wrócić do normalnej aktywności, w tym kąpieli w wannie, pływania w basenie czy korzystania z sauny. Unikaj jednak bezpośrednich uderzeń w okolicę portu oraz noszenia ciasnych pasków od torebek czy plecaków przebiegających przez miejsce implantacji. Sporty kontaktowe (piłka nożna, koszykówka, sztuki walki) wymagają konsultacji z lekarzem. Przed każdą procedurą medyczną Zawsze informuj personel medyczny o posiadanym porcie naczyniowym – zarówno przed badaniami obrazowymi (MR czy TK), jak i przed jakimikolwiek zabiegami chirurgicznymi. Noś przy sobie kartę portu z informacjami o typie i dacie implantacji. Wszystkie modele portów naczyniowych stosowanych w Klinice Flebologii posiada status MR conditional (warunkowo bezpieczny) lub MR safe (całkowicie bezpieczny). W tym pierwszym przypadku oznacza to, że można bezpiecznie wykonywać rezonans w skanerach o natężeniu pola 1.5 oraz 3 Tesle (standardowe urządzenia w diagnostyce). W przypadku tych drugich wykonanych całkowicie z tworzywa wolnego od metalu badanie MR jest całkowicie bezpieczne. Mostlyquestions asked Czy port naczyniowy jest widoczny pod skórą? Port naczyniowy po zagojeniu jest niemal niewidoczny. Może być wyczuwalny jako niewielkie, twarde uwypuklenie o średnicy monety (ok. 2-3 cm). Dzięki temu, że urządzenie znajduje się całkowicie pod skórą, pacjent zachowuje pełną dyskrecję i estetykę wyglądu. Czy procedura zakładania portu naczyniowego jest bolesna? Zabieg implantacji portu naczyniowego wykonywany jest w znieczuleniu miejscowym lub dodatkowo z zastosowaniem płytkiej sedacji, dzięki czemu Pacjent praktycznie nie odczuwa bólu. Po zabiegu może wystąpić niewielka bolesność w okolicy rany, łatwa do opanowania standardowymi lekami przeciwbólowymi. Czy z portem naczyniowym można normalnie funkcjonować? Tak. Port naczyniowy jest umieszczony pod skórą i po wygojeniu rany nie ogranicza codziennej aktywności. Można się kąpać, pływać (po pełnym wygojeniu) i uprawiać sporty, które nie angażują intensywnie obręczy barkowej. Dlaczego port naczyniowy jest lepszy od zwykłego wkłucia? W przeciwieństwie do tradycyjnych wkłuć do żył obwodowych (np. w zgięciu łokcia), port chroni naczynia przed stanami zapalnymi wywołanymi przez agresywne leki (chemioterapię) i eliminuje ból związany z wielokrotnym nakłuwaniem. Jak długo można używać portu naczyniowego? Przy prawidłowej pielęgnacji port może służyć Pacjentowi przez wiele lat (5–10 lat). Po zakończeniu leczenia port może zostać usunięty w czasie krótkiego zabiegu wykonywanego w warunkach ambulatoryjnych. Treatment methods 01 / Microsclerotherapy 02 / Foam sclerotherapy 03 / Laser vein sealing 04 / Varicose vein taping 05 / Miniflebectomy 06 / Venous embolisation Bezpieczny port Zastosuj nowoczesny port naczyniowy.Daj odpocząć swoim żyłom. Postaw na bezpieczeństwo i komfort. Make an appointment Make an appointment at the Phlebology Clinic Give us a call!
