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Ports
Anatoly Loskutov, MD; Brandt C. Wible, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Outcomes

          TERMINOLOGY

          • Definitions

            • Port catheter: Totally implantable central venous access device consisting of subcutaneous access port and venous catheter attachment
              • Used to provide long-term central venous access
                • Typically needed for months to years
              • Port reservoir construction
                • Silicon disc in plastic or titanium body
                • Permits 1,000-2,000 accesses (19- to 22-g Huber point noncoring needles)
              • Catheter construction
                • 6- to 16-Fr catheter sizes
                • Silicon rubber/polyurethane material
                • Preattached or attachable
                • Groshong valve: Flushes with normal saline only
                  • Advantageous if heparin allergy
              • a.k.a.
                • Implantable subcutaneous port
                • Port-a-cath
                • Venous access device
            • Port configurations/specifications
              • Single- or dual-lumen port
                • Power injectable: Accommodates contrast injection rates used in CECT
                  • 300 psi, 2-5 mL/s maximum infusion rate
                  • Standard port placed at many institutions
                • Low profile: Ideal for cachectic/thin patients, arm placement
                  • Smaller port height, decreased bulge under skin
                  • Decreased risk of port erosion
                • Mini/small profile: Pediatric/small patients
                  • Allows small pocket/less surrounding soft tissue
                • Dual lumen: Patients requiring medications/chemotherapy in addition to total parenteral nutrition (TPN)
                  • 1 lumen often dedicated to TPN delivery

          PREPROCEDURE

          • Indications

            • Contraindications

              • Preprocedure Imaging

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Equipment Preparation

                      • Procedure Steps

                        • Alternative Procedures/Therapies

                          POST PROCEDURE

                          • Expected Outcome

                            • Things to Do

                              • Things to Avoid

                                OUTCOMES

                                • Complications

                                  • Management of Port Catheter-Specific Complications

                                    • Expected Outcomes

                                      Selected References

                                      1. Coady K et al: A comparison of infections and complications in central venous catheters in adults with solid tumours. J Vasc Access. 16(1):38-41, 2015
                                      2. Gurkan S et al: Retrospective evaluation of totally implantable venous access port devices: early and late complications. J BUON. 20(1):338-45, 2015
                                      3. Granic M et al: Totally implantable central venous catheters of the port-a-cath type: complications due to its use in the treatment of cancer patients. J BUON. 19(3):842-6, 2014
                                      4. Gonda SJ et al: Principles of subcutaneous port placement. Tech Vasc Interv Radiol. 14(4):198-203, 2011
                                      5. Pardo I et al: Central venous port placement: a comparison of axillary versus anterior chest wall placement. Ann Surg Oncol. 18(2):468-71, 2011
                                      6. Dariushnia SR et al: Quality improvement guidelines for central venous access. J Vasc Interv Radiol. 21(7):976-81, 2010
                                      7. Goltz JP et al: Peripherally placed totally implantable venous-access port systems of the forearm: clinical experience in 763 consecutive patients. Cardiovasc Intervent Radiol. 33(6):1159-67, 2010
                                      8. Scaife CL et al: Antibiotic prophylaxis in the placement of totally implanted central venous access ports. Am J Surg. 200(6):719-22, 2010
                                      9. Zawacki WJ et al: Wound dehiscence or failure to heal following venous access port placement in patients receiving bevacizumab therapy. J Vasc Interv Radiol. 20(5):624-7; quiz 571, 2009
                                      10. Gebauer B et al: Radiological interventions for correction of central venous port catheter migrations. Cardiovasc Intervent Radiol. 30(4):668-74, 2007
                                      11. Kuriakose P et al: Risk of deep venous thrombosis associated with chest versus arm central venous subcutaneous port catheters: a 5-year single-institution retrospective study. J Vasc Interv Radiol. 13(2 Pt 1):179-84, 2002
                                      12. Bodner LJ et al: Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol. 23(3):187-93, 2000
                                      13. Biffi R et al: Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol. 9(7):767-73, 1998
                                      14. Simpson KR et al: Interventional radiologic placement of chest wall ports: results and complications in 161 consecutive placements. J Vasc Interv Radiol. 8(2):189-95, 1997
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Preprocedure

                                          • Procedure

                                            • Outcomes

                                              TERMINOLOGY

                                              • Definitions

                                                • Port catheter: Totally implantable central venous access device consisting of subcutaneous access port and venous catheter attachment
                                                  • Used to provide long-term central venous access
                                                    • Typically needed for months to years
                                                  • Port reservoir construction
                                                    • Silicon disc in plastic or titanium body
                                                    • Permits 1,000-2,000 accesses (19- to 22-g Huber point noncoring needles)
                                                  • Catheter construction
                                                    • 6- to 16-Fr catheter sizes
                                                    • Silicon rubber/polyurethane material
                                                    • Preattached or attachable
                                                    • Groshong valve: Flushes with normal saline only
                                                      • Advantageous if heparin allergy
                                                  • a.k.a.
                                                    • Implantable subcutaneous port
                                                    • Port-a-cath
                                                    • Venous access device
                                                • Port configurations/specifications
                                                  • Single- or dual-lumen port
                                                    • Power injectable: Accommodates contrast injection rates used in CECT
                                                      • 300 psi, 2-5 mL/s maximum infusion rate
                                                      • Standard port placed at many institutions
                                                    • Low profile: Ideal for cachectic/thin patients, arm placement
                                                      • Smaller port height, decreased bulge under skin
                                                      • Decreased risk of port erosion
                                                    • Mini/small profile: Pediatric/small patients
                                                      • Allows small pocket/less surrounding soft tissue
                                                    • Dual lumen: Patients requiring medications/chemotherapy in addition to total parenteral nutrition (TPN)
                                                      • 1 lumen often dedicated to TPN delivery

                                              PREPROCEDURE

                                              • Indications

                                                • Contraindications

                                                  • Preprocedure Imaging

                                                    • Getting Started

                                                      PROCEDURE

                                                      • Patient Position/Location

                                                        • Equipment Preparation

                                                          • Procedure Steps

                                                            • Alternative Procedures/Therapies

                                                              POST PROCEDURE

                                                              • Expected Outcome

                                                                • Things to Do

                                                                  • Things to Avoid

                                                                    OUTCOMES

                                                                    • Complications

                                                                      • Management of Port Catheter-Specific Complications

                                                                        • Expected Outcomes

                                                                          Selected References

                                                                          1. Coady K et al: A comparison of infections and complications in central venous catheters in adults with solid tumours. J Vasc Access. 16(1):38-41, 2015
                                                                          2. Gurkan S et al: Retrospective evaluation of totally implantable venous access port devices: early and late complications. J BUON. 20(1):338-45, 2015
                                                                          3. Granic M et al: Totally implantable central venous catheters of the port-a-cath type: complications due to its use in the treatment of cancer patients. J BUON. 19(3):842-6, 2014
                                                                          4. Gonda SJ et al: Principles of subcutaneous port placement. Tech Vasc Interv Radiol. 14(4):198-203, 2011
                                                                          5. Pardo I et al: Central venous port placement: a comparison of axillary versus anterior chest wall placement. Ann Surg Oncol. 18(2):468-71, 2011
                                                                          6. Dariushnia SR et al: Quality improvement guidelines for central venous access. J Vasc Interv Radiol. 21(7):976-81, 2010
                                                                          7. Goltz JP et al: Peripherally placed totally implantable venous-access port systems of the forearm: clinical experience in 763 consecutive patients. Cardiovasc Intervent Radiol. 33(6):1159-67, 2010
                                                                          8. Scaife CL et al: Antibiotic prophylaxis in the placement of totally implanted central venous access ports. Am J Surg. 200(6):719-22, 2010
                                                                          9. Zawacki WJ et al: Wound dehiscence or failure to heal following venous access port placement in patients receiving bevacizumab therapy. J Vasc Interv Radiol. 20(5):624-7; quiz 571, 2009
                                                                          10. Gebauer B et al: Radiological interventions for correction of central venous port catheter migrations. Cardiovasc Intervent Radiol. 30(4):668-74, 2007
                                                                          11. Kuriakose P et al: Risk of deep venous thrombosis associated with chest versus arm central venous subcutaneous port catheters: a 5-year single-institution retrospective study. J Vasc Interv Radiol. 13(2 Pt 1):179-84, 2002
                                                                          12. Bodner LJ et al: Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol. 23(3):187-93, 2000
                                                                          13. Biffi R et al: Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol. 9(7):767-73, 1998
                                                                          14. Simpson KR et al: Interventional radiologic placement of chest wall ports: results and complications in 161 consecutive placements. J Vasc Interv Radiol. 8(2):189-95, 1997