Central Venous Catheter Insertion – Venous Ports Patient information leaflet (278kB pdf)
Introduction
We hope this guide will answer your questions about your central venous port (also
known as portacath or “implantable venous access port”). Please contact the team if you require further information via the details at the end of this leaflet.
What is a central venous port?
A central venous port (also known as portacath or “implantable venous access port”) is a small, implanted device placed under the skin that allows for long term access to a large vein near the heart. It is used to administer medication, fluids or draw blood directly through a needle inserted into the port itself. It is implanted beneath the skin for convenient access to the blood stream over extended periods, often used in cancer treatment.
Why do I need a central venous port?
Your doctor should have explained the reason why you need this examination. Ports may be used for several purposes, including delivering long-term medications or nutrition, for taking blood tests and for injecting contrast dye if you are having frequent scans. The port can be safely left in place for as long as treatment is required, which can be months or years. To prevent the portacath from becoming blocked, it will need to be maintained by flushing. This can be done at home, in the clinic, or by a carer. The major benefit of a portacath is that you will not require repeated injections or cannulas (small plastic tubes that are placed in the veins of the hands or arms, which have to be changed every few days) for ongoing treatment.
What are the associated risks?
X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor along with the radiologists have determined that the benefits of having the examination outweigh potential risks. The radiographer is present throughout your test making sure that the radiation dose is kept as low as reasonably possible and the duration and level of x-rays are kept to a minimum.
Contrast medium: A very small number of patients have an allergic reaction to the contrast medium (x-ray dye). This can be minor, severe, or even life threatening but the chances of this occurring are very rare. If you get an itchy rash or difficulty breathing during the procedure tell a member of staff, the team will provide appropriate treatment. Before your examination begins the radiographer will ask you a series of questions about your medical history, including any allergies you may have. This will help us assess if you are at risk of an allergic reaction to the x-ray dye.
Procedure: There is a small risk of bleeding when the incisions are made to insert the catheter. As the central venous device has direct access to the bloodstream, infection can be a risk after the procedure. There is also a small risk of puncturing the chest and causing the lung to collapse, which is extremely rare and can be treated.
Blockage: The line can also become blocked or dislodged, which can sometimes be corrected, but occasionally requires replacement.
Will I need an injection?
Occasionally, patients are given antibiotics, sedative and painkillers through a cannula placed in your arm.
Preparing for your procedure
Central Venous Port insertion is usually carried out as a day case procedure under local anaesthetic. Please do not have anything to eat for 4 hours prior to your procedure. You must still drink clear fluids such as water prior to your procedure. Please contact the booking team before your appointment if:
- you are or think you may be pregnant
- you have had a previous allergic reaction to contrast medium (X-ray dye) or are allergic to iodine.
- you weigh over 30 stone/190 kilograms
- you plan on using hospital transport or need a hoist to transfer
- you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you
Please leave any jewellery or valuables at home.
If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.
Allergies
If you have asthma or any allergies, especially to iodine or contrast medium (X-ray dye), please inform us in advance.
Medication
Please continue to take all medications as usual, prior to your examination, unless you have been told otherwise.
Getting to us
Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.
When should I arrive?
Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.
Can someone stay with me in hospital?
You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.
The day of the procedure
You will be shown to a cubicle and asked to undress and put on a gown; please bring a dressing gown if you have one. You may also be asked to remove jewellery, dentures, glasses, or other metal objects, which may show up on the X-rays.
The procedure
Your identification will be checked by a nurse and radiographer, a brief history will be taken; please tell the radiologist what medication, severe allergies, choking episodes or other medical conditions, such as thyroid disease and diabetes you may have. Before the procedure, the interventional radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish. The procedure is normally performed awake under local anaesthesia, which is used to temporarily numb the skin. After the skin is cleaned with antiseptic skin preparation, local anaesthetic is injected into the skin of your chest, and the chamber is inserted in to place, via a small skin incision. The catheter attached to the chamber is brought under the skin to the neck. A second tiny cut (incision) is made in the skin of the neck and a needle passed into the vein underneath, enabling the catheter to be guided into position with ultrasound and x-ray. The cut in the neck is closed with a stitch. The chest incision is closed with deep stitches also. Medical and nursing staff will then be able to deliver intravenous medications by feeling the ‘bump’ under the skin and then passing a needle through the skin into the chamber. Medications delivered into the chamber pass through the catheter into the central vein.
After the procedure
Nursing staff will carry out routine observations including pulse and blood pressure and will also check the treatment site. You will generally stay in bed for a couple of hours and then you will be able to go home. You will be given an aftercare leaflet with information following your procedure. Take it easy for the rest of the day but you can resume normal activities the next day.
Can I drive after my procedure?
No, it is important that you have a responsible adult to escort you home. You must not drive or use public transport for the journey home.
How soon can I return to work?
It is recommended that you rest for the remainder of the day. Avoid heavy lifting and gym exercise. You can return back to work after 48 hours
When will I get my results?
You will not know the results of your examination immediately. The radiologist will report their findings to the clinician who arranged your procedure, who will discuss the results with you. It usually takes a couple of weeks for the results to become available.
Contacting the team
- If you have any further questions about your procedure or an existing appointment, please contact the radiology department (Monday to Friday, 9am to 4pm) at 01279 82 2527 or 3405
- If you have any queries outside of working hours (after 4pm and on weekends), you will be redirected to the main radiology reception. Please note appointment bookings cannot be made during this time.
Your feedback matters
- If you would like to give feedback on your care, please contact our patient experience team at [email protected] or01279 827211.
- Please contact the communications team at [email protected] if you would like this leaflet in another language or format.