What Are MIIPs? / Port or Portacath

What is a port?

A port (or portacath) is a small device that provides long-term access to a patient’s vein to give them medicines or draw blood.

The port sits under the skin below the collarbone or, less commonly, in the upper arm.

What are the parts of a port?

• small metal or plastic well
  
• the rubbery roof on the well is made to be punctured with a special needle
• the well is connected to a thin plastic tube, the tube is tunneled under the skin and ends in a big vein leading to the heart

What are the advantages of a port over an IV or other central line?

A port allows a patient to avoid having to get stuck in the arm every time they need medicine or a blood draw. Also, some medicines are too strong for the small veins so they need to be given into the big veins near the heart.

• Can stay in place for months to years
• Minimal pain to use
• Lower risk of infection
• Patients can swim and bathe normally because the port is entirely under the skin

Who places ports?

In the past, ports were placed by a surgeon using anesthesia. Nowadays, most ports are placed by an Interventional Radiologist (IR) in a safe minimally invasive, image-guided procedure (MIIP).

How does the IR doctor place a port?

1. After cleaning the skin, the IR doctor numbs the skin in two spots: at the base of the neck and on the chest below the collarbone. 
2. The IR places the port in a pocket under the skin of the chest through a short incision. 
3. The IR tunnels the tubing under the skin to the neck then places it into the vein through a small knick in the skin. 
4. The IR watches with X-rays while positioning the tubing near the heart.
5. The IR then closes the port pocket with stitches.

Is port placement a safe procedure?

This MIIP is safe for 2 main reasons:

1. IRs use radiology pictures to make sure the port is in the right place.
2. Patients only need local numbing medicine or medicine to cause drowsiness, so they do not have the risks of anesthesia.

This MIIP usually takes an hour or less. Most patients can have their port placed as an outpatient, meaning they go home the same day.

Who could benefit from a port?

• Patients with cancer who need chemotherapy
• Patients with chronic diseases like cystic fibrosis or other diseases requiring long-term antibiotics or blood exchanges.
• Patients who need frequent blood draws but have poor vein access