For patients who consistently require chemotherapy treatments, the portacath is a device that simplifies part of the process. A portacath is a small device placed under the skin that allows for easy, recurring access to blood vessels. At Premier Vein and Vascular Center, this procedure is performed by highly experienced doctors who have performed thousands of such procedures.
Quick Answer: A portacath placement is a short outpatient procedure in which an interventional radiologist places a small reservoir under the skin of the chest or arm, connected by a thin catheter to a large vein just above the heart. Using ultrasound and X-ray guidance, light sedation and local anesthetic, the procedure usually takes about half an hour, and most patients go home the same day. The port gives nurses reliable access for chemotherapy, infusions and blood draws without repeated needle sticks in the arms.
Meet your vein specialist
Dr. Syed Raza, MD
Vascular & Interventional Radiology · Founder, Premier Vein & Vascular Center
Fellowship-trained interventional radiologist, board certified in diagnostic and interventional radiology with a Certificate of Added Qualification (CAQ) in interventional radiology, and a Fellow of the Royal College of Radiologists (UK). Member of SIR and RSNA. Former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City, with 15+ years treating varicose veins, venous reflux and peripheral arterial disease.
About Portacaths
The device consists of four major components: the septum, portal, catheter connector, and catheter.
- Septum – the tight silicone mesh separating the skin from the portal
- Portal – allows for anything to be injected (medications) or collected (blood samples) via a needle, which can slip through the septum
- Catheter connector – links the portal to the catheter
- Catheter – runs into a central vein
Portacaths allow doctors to insert needles repeatedly into a single opening on the skin to efficiently administer chemotherapy medications and collect blood samples. This eliminates a need for searching for a blood vessel (vein) any time an injection or sample is needed. Some of the medications used for chemotherapy are highly toxic and can damage smaller blood vessels, possibly causing them to leak and damage surrounding tissue. By sending these medicines into the port and then directly to a larger central vein, the likelihood of this occurring is reduced, as they are diluted more rapidly by the flow of blood.
Portacaths can be placed in one of two locations: in the chest or the arm. Chest placement is the most common, and the catheter links to a vein just above the heart. With an arm placement, the catheter also links to a vessel just above the heart, but depending on where the port is placed, it may require a longer catheter. The procedure to implant a portacath takes about half an hour and is performed by an interventional radiologist.
Before the Procedure
In preparation for the procedure, the patient will be asked not to eat or drink anything after midnight on the start of the procedure day. Water and medications are allowed until the procedure is to take place, but it is best to consult with your doctor beforehand to avoid any mishaps. If the patient takes aspirin, plavix, or warfarin, the doctor must be notified so he or she can tell the patient when to cease taking the medication prior to the procedure. The day after the procedure is done, the patient can resume taking these medicines as directed.
During the Procedure
The procedure site is numbed with a local anesthetic and the patient is also given an IV for sedation. The doctor will make a three (3) cm incision in the chest or arm to place the port and a five (5) mm incision in the neck to enter the vein. The portal itself is placed completely under the skin (subdermal) and the catheter is connected to the portal at one end and inserted into the vein at the other end, near the 5 mm incision. Once inserted properly, the procedure is complete.
After the Procedure
After the portacath placement, there may be some redness and tenderness around the procedure site. This should clear up within two days, but if it persists beyond two to three days, especially if it is continually draining, your doctor’s office should be notified immediately. Strenuous exercise involving the chest and arms should be avoided for at least 10 days after the procedure, as well as physical activity that involves repetitive motion of the chest and arms, including swimming, golfing, and weight lifting; this can cause damage to the catheter. If the port isn’t used within one week of placement, a doctor should be consulted for a wound care checkup and a change of dressing. If the portacath is not being used at all, the doctor will need to flush the port with saline water and heparin every few weeks to prevent clotting.
It is important that the port site be kept clean. When no needle is attached to the port, a person can carry on as usual, making sure the port site is kept clean. They can also shower or bathe as normal. When a needle is attached, it will be covered with a dressing to keep the needle in place and keep the site clean. Infection risks are low, but cancer patients may have catheter related bloodstream infections if the port is not kept clean. If an infection does occur, the port will be removed and the patient will be treated with antibiotics. Blood clots can form in the catheter, but this is usually prevented by flushing the port regularly after drawing blood. During chemotherapy treatments, irritation can occur in the skin around the port.
Portacaths can stay in for as long as a doctor deems necessary, but if it is not in use, it must be flushed every 4-6 weeks. MRIs can be conducted with the port, but the MRI technician should be notified that there is a portacath. Portacaths will not set off most security detectors, but a Port ID card should still be carried in case one does detect it. If you notice any skin changes at the port site, or if fluids are not flowing freely through the port, contact your doctor and do not inject anything into the port without instruction to do so from a doctor or nurse.
Who Needs a Portacath?
A port is designed for people who will need reliable access to their veins for months rather than days. Oncologists most often recommend one for patients starting chemotherapy, especially when treatment involves medicines that irritate small veins, infusions that last several hours, or a schedule that runs for many cycles. Ports are also used for some patients who need long-term intravenous nutrition, repeated blood transfusions, frequent blood draws or prolonged courses of intravenous therapy.
Patients whose arm veins are small, scarred or hard to find benefit in particular. Instead of repeated needle sticks and searching for a usable vein before every treatment, the nurse accesses the same reliable spot each time. Many patients tell us the biggest change is simply less worry before each infusion day.
Portacath vs PICC Line vs Other Central Lines
A port is one of several types of central venous access device. Your oncology team and interventional radiologist choose the type based on how long you will need it, what it will be used for and your lifestyle.
| Device | Where it sits | Typical duration | Daily life | Maintenance |
|---|---|---|---|---|
| Implanted port (portacath) | Completely under the skin of the chest or arm | Months to years | Nothing outside the body when not accessed; normal showering and, once healed, most activities | Flushing every few weeks when not in use |
| PICC line | Inserted in an upper arm vein, with tubing outside the skin | Weeks to a few months | Tubing must be kept dry and covered; swimming is not allowed | Weekly dressing change and regular flushing |
| Tunneled central catheter | Enters a neck or chest vein, with tubing exiting the chest | Weeks to months | External tubing to protect and keep dry | Regular dressing changes and flushing |
| Peripheral IV | A small vein in the hand or arm | Hours to a few days | Replaced for each treatment | None long term, but repeated sticks |
For many patients receiving chemotherapy over several months, the port offers the best balance of reliability, low daily maintenance and freedom from external tubing.
Image Guidance: Why an Interventional Radiologist Places Your Port
Interventional radiologists place ports using real-time ultrasound to find and enter the vein and X-ray imaging to position the catheter tip precisely where the blood flow is strongest, just above the heart. This image-guided approach allows a small, accurate access point and lets the physician confirm the final position before you leave the procedure room. Learn more about our ultrasound-guided procedures.
Many modern ports are also rated for power injection, which means they can be used for the contrast injections needed during CT scans. If your port is this type, you will receive a card and sometimes a bracelet that identifies it. Keep that card with you, along with the Port ID card mentioned above.
Preparing for Your Port Placement
In addition to the fasting and blood thinner instructions above, a few practical steps make the day go smoothly:
- Arrange for an adult to drive you home, since you will receive sedation
- Wear a loose, button-front top that is easy to put on over a fresh dressing
- Bring a list of all your medications, including diabetes medicines and supplements
- Tell us about any allergies, prior surgery on the chest or neck, or previous central lines
- Let us know if your first chemotherapy session is already scheduled, so placement can be timed appropriately
If you have a preference for which side the port goes on, for example to avoid the side where you carry a bag or wear a seat belt, mention it. Sometimes the side is determined by medical factors such as previous breast surgery, but when there is a choice, comfort matters.
Living With a Port Day to Day
Once the incision has healed, most people forget the port is there for much of the time. A few tips help:
- A small seat belt pad can make car journeys more comfortable if the belt crosses the port
- Numbing cream applied before infusion appointments, if your oncology team allows it, can reduce the sting of access
- Look at the skin over the port regularly for redness, swelling or thinning
- Keep a note of the date of your last flush if you are between treatment cycles
- Mention the port to any new doctor, dentist or imaging center before a procedure or scan
Patients sometimes worry about hugging, sleeping on their side or carrying children. Once healed, these are generally fine. If something presses uncomfortably on the port, a small change in position or padding usually solves it.
Port Removal When Treatment Ends
When your oncologist confirms that the port is no longer needed, it can be removed in a short outpatient procedure with local anesthetic and, if you wish, light sedation. The previous incision is usually reopened, the port and catheter are taken out, and the skin is closed. Most people return to normal activity within a day or two. Some patients prefer to keep the port for a period after treatment in case it is needed again; this is a decision to make together with your oncologist.
Call your care team right away, or seek emergency care, if you notice:
- Fever of 100.4 F (38 C) or higher, or chills, especially during or after a port flush or infusion
- Redness, warmth, pus or increasing pain around the port
- Swelling of the arm, neck or face on the side of the port, which can signal a clot
- Sudden shortness of breath or chest pain
- Fluid leaking under the skin or pain during an infusion
How We Evaluate Patients for Port Placement
- Review of your treatment plan. We confirm with your oncology team what the port will be used for, when treatment starts and how long it is expected to continue.
- Health history and labs. We review medications, especially blood thinners, allergies and recent blood counts and clotting tests as needed.
- Vein assessment. A quick ultrasound of the neck and chest veins confirms they are open and suitable.
- A clear plan. We explain where the port will go, what to expect on the day, and how to care for it afterward, and we send placement details back to your oncologist.
Portacath Placement in Houston
Dr. Syed Raza is a fellowship-trained interventional radiologist and former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City, with more than 15 years of experience in image-guided procedures. Our team works closely with oncologists across Houston and Katy to schedule placements promptly so that treatment can begin on time, and we accept most insurance plans, including Medicare. To learn more, visit our portacath placement and venous access pages, see how we support oncology treatment, or contact our Houston interventional radiology clinic.
Talk With a Specialist at Premier Vein
Have questions about your symptoms or treatment options? Dr. Syed Raza and the team at Premier Vein & Vascular Center can evaluate your concerns and explain your options clearly. Same-week appointments are usually available, and most insurance plans are accepted.
Frequently Asked Questions
Does getting a port hurt?
The area is numbed with local anesthetic and you receive sedation through an IV, so most patients feel little during placement. Some soreness and bruising for a few days afterward is common and usually managed with simple pain relief your doctor approves.
How soon can a port be used after placement?
In many cases a port can be used the same day or within a day or two, depending on your oncology team’s protocol and how the incision looks. Your care team will tell you when your first access is planned.
Can you feel a port under the skin?
Yes. You can usually feel a small, firm bump under the skin, and in slimmer people it may be slightly visible. Most patients get used to it quickly and find it does not interfere with clothing or daily activities.
How long can a portacath stay in?
A port can remain in place for months or years, as long as it is working well, is not infected and is still needed. When treatment is complete, your oncologist will decide when it should be removed.
Is a port better than a PICC line for chemotherapy?
For treatment lasting several months, many patients and oncologists prefer a port because it sits fully under the skin, needs less maintenance and allows showering and most activities. A PICC line may be chosen for shorter courses. The choice depends on your treatment plan.
Can I swim or exercise with a port?
Once the incision has fully healed and the port is not accessed, most people can return to swimming and exercise. Avoid strenuous chest and arm activity during the early healing period described above, and ask your doctor before resuming contact sports.