Portacaths

A portacath is a type of central line. It is sometimes called a port or a totally implantable venous access device (TIVAD). You might have one for chemotherapy and other drugs and fluids.

It is a small chamber that sits under your skin. It’s attached to a long plastic tube that goes into a large vein close to your heart. You can feel the chamber of the portacath, but unless you’re very thin you can’t usually see it.

You have sedation or a general anaesthetic to have the portacath put in place. Your doctor or nurse will make 2 small cuts on your chest. One is to make a pocket for the portacath to sit in. The other is to insert the plastic tube. You will have an x-ray to check the tube is in the right place.

The main advantage of a portacath is that you can't see it on the outside of your body. You don't have a tube coming out of your chest, as you do with other types of central line.

How it works

When you need treatment, your chemotherapy nurse puts a needle into the chamber. You have treatment through the needle as an injection or drip (infusion). 

The drugs travel from the chamber to the tubing and into your bloodstream. The portacath stays in place for as long as you need treatment. 

Some people don't like having a needle put in each time they need treatment. Ask your nurse to numb the area over the portacath with a local anaesthetic cream before the needle goes in. 

The nurse removes the needle after each treatment.

Possible problems

Sometimes problems can happen with portacaths: 

• you may get an infection

• the line may get blocked

• a blood clot can develop

• a portacath may split, but this is very rare

Your nurse will test your portacath each time they use it. They will check for blood return and inject it with salt water (saline). This is called flushing. It’s very important to tell your nurse if you experience pain around the portacath. This could mean the portacath has split or the needle is in the incorrect place.

If you are not having treatment, you or your nurse need to clean and flush the line regularly. It is flushed with heparin and saline to clean the line and prevent clotting. The nurses on the ward can teach you or your carer how to do this. Your district nurse can care for your line or help you at home at first.

It’s very important to avoid getting an infection in the area where your portacath goes into your body. Speak to your chemotherapy nurse or doctor if you notice any redness, swelling, oozing or soreness. These could be signs of infection.

You need to have treatment with antibiotics straight away if you do develop an infection. Otherwise, a doctor or nurse may have to remove the line and put a new one in.

Everyday life with a portacath

You can go home with a portacath in place. There are very few restrictions to your everyday life.

It’s fine to have a bath or shower. Once the stitches have healed you can go swimming. But it’s important to check with your doctor first if you’re having chemotherapy. There may be an infection risk from using a public pool. 

Before you go home, make sure you’re confident about looking after your line. Ask the staff on the ward if you’re not sure about anything. They can arrange for district nurses to visit you at home to help with the line until you feel confident.

Contact your advice line if you have any problems at home.