A portacath (also called a port-a-cath, implanted port, or simply “port”) is a small medical device placed entirely under your skin that gives healthcare providers easy, reliable access to your bloodstream. It’s most commonly used for chemotherapy, but any treatment requiring frequent or long-term intravenous access can be a reason to get one. The device sits beneath the skin of your upper chest, arm, or abdomen and connects to a large vein near your heart through a thin, flexible tube.
How a Portacath Works
A portacath has three main parts: the port body, a connector, and a catheter. The port body is a small, disc-shaped reservoir, roughly the size of a quarter, with a thick silicone membrane on top called a septum. This septum is designed to reseal itself after being punctured hundreds of times. The catheter is a thin, flexible tube that runs from the port through a vein and ends near the heart, where blood flow is strong enough to quickly dilute medications.
When you need treatment, a nurse inserts a special needle called a non-coring (or Huber) needle through your skin and into the septum. Unlike a regular needle, this type doesn’t cut a core out of the silicone, which is what allows the septum to reseal cleanly each time. Medications, fluids, or blood products flow through the needle into the port reservoir, through the catheter, and directly into your bloodstream.
Why Doctors Recommend One
Standard IVs work fine for short treatments, but they need to be replaced every few days and can irritate smaller veins. Certain chemotherapy drugs are harsh enough to damage peripheral veins entirely. A portacath solves both problems: it delivers medications into a large, high-flow vein where they’re diluted immediately, and it can stay in place for months or years.
Ports are used for chemotherapy, long-term antibiotic therapy, repeated blood transfusions, and parenteral nutrition (IV feeding). They’re also used for patients who need frequent blood draws. Some ports, called power ports, are built to handle the high-pressure injections needed for contrast dye during CT scans. These are designed to withstand injection rates of 5 milliliters per second at 300 psi and are identifiable on X-rays by the letters “CT” printed on the device. If you know you’ll need contrast-enhanced imaging during treatment, a power port can save you from needing a separate IV line each time.
The Placement Procedure
Port placement is a minor surgical procedure, typically done in an operating room or specialized procedure suite. You’ll receive light sedation along with local anesthesia to numb the area. The whole process usually takes under an hour.
Your surgeon makes a small incision in the neck area to access a large vein, most commonly the internal jugular or subclavian vein. A second small incision, usually on the upper chest, creates a pocket just under the skin where the port body is placed. The catheter is threaded from the port through the vein until its tip sits near the heart. Continuous X-ray imaging (fluoroscopy) guides the placement in real time, and a chest X-ray confirms everything is positioned correctly before the incisions are closed with dissolvable stitches.
The incision area typically takes about six weeks to fully heal. During that time, you’ll want to avoid scrubbing the site or submerging it in water.
What It Feels Like Day to Day
Once healed, most people can see a small bump under the skin where the port sits, and you can feel the edges of the device if you press on it. It’s not visible through most clothing. Because it’s fully under the skin, there’s no external tubing or dressing to manage between treatments, which is a major quality-of-life advantage over other central lines like PICC lines.
When the port is accessed for treatment, a nurse cleans the skin over the port and inserts the non-coring needle. The needle stick feels like a firm pinch. Many patients use a numbing cream or lidocaine spray applied five to ten minutes beforehand to reduce discomfort. Once the needle is in and secured with a clear dressing, you can receive treatment normally.
Between uses, you can shower, bathe, and even swim, as long as the port isn’t currently accessed with a needle. If you do go home with the port accessed (some patients keep it accessed for continuous infusions), the dressing needs to be covered with a waterproof barrier before getting wet.
Activity and Exercise
After the initial healing period, most normal activities are fine. However, Memorial Sloan Kettering Cancer Center advises checking with your care team before running, stretching vigorously, lifting anything over 10 pounds, or playing contact sports like football. The concern is less about the port itself breaking and more about catheter displacement or trauma to the port site. Many patients exercise regularly with a port in place, but your specific activity level should be guided by your medical team’s recommendations based on port location and your overall health.
Keeping the Port Functional
A portacath needs to be flushed periodically to prevent blood clots from blocking the catheter. After each use, the port is flushed with saline or a dilute heparin solution (an anticoagulant) to keep the line clear. When the port isn’t being used between treatment cycles, standard practice calls for a flush every four to eight weeks, though some centers have moved to every 90 days based on evidence that monthly flushing may be more frequent than necessary.
You’ll need to visit a clinic or infusion center for these flushes. They take only a few minutes: a nurse accesses the port, pushes saline or heparin through, and removes the needle. Research has shown that saline alone is comparable to heparin for maintaining patency, and practices vary by institution.
Possible Complications
Portacaths are generally reliable, but they carry risks. A large 10-year study of over 1,700 cancer patients found an overall complication rate of 18.5%. Most were late complications, meaning they developed well after placement rather than during surgery.
The most common issues were:
- Infection: Occurred in 3.9% of patients, including bloodstream infections (1.9%), infections in the port pocket (1.4%), and skin infections at the site (0.6%). Signs include redness, swelling, warmth around the port, or fever and chills during or after use.
- Blood clots: Catheter-related thrombosis affected 3.2% of patients. A clot can form around the catheter tip or inside the port, potentially causing swelling in the arm or neck on the side of the port.
- Catheter problems: Less commonly, the catheter can shift out of position, fracture, or become pinched. These issues are typically caught on imaging and may require the port to be repositioned or replaced.
Early complications from the placement procedure itself, such as bleeding or a collapsed lung (pneumothorax), occurred in 5.5% of cases in that study. These are usually identified immediately through the post-procedure X-ray.
How Long a Port Lasts
Ports can remain in place for years. In one study of breast cancer patients, the median time a port stayed implanted was about 15 months, with some lasting over seven years. The septum is rated for a specific number of punctures (typically 1,000 to 2,000, depending on the manufacturer), so the physical device itself can outlast most treatment courses.
Removal is considered in two situations: when a serious complication makes the port unsafe to keep using, or when treatment is finished and the port is no longer needed. For breast cancer patients who no longer need regular IV treatment, some guidelines suggest considering removal after about two years to avoid the ongoing need for maintenance flushes and to reduce the small but cumulative risk of complications like clots or infection. Removal is a minor outpatient procedure, simpler and quicker than the original placement.
Ports vs. PICC Lines and Other Options
If you’ve been offered a port, you may be weighing it against a PICC line, which is a long catheter inserted through a vein in the arm with an external hub that sits outside the body. PICC lines are easier to place (no surgery needed) but require daily or weekly dressing changes, limit arm movement, restrict swimming and bathing, and carry a higher infection risk over time. They’re better suited for treatments lasting weeks to a few months.
A portacath makes more sense when treatment will last several months or longer, when you want more freedom between infusion days, or when you need high-pressure contrast injections for imaging. The tradeoff is a minor surgical procedure upfront and the needle stick at each access, but for most patients on long treatment plans, the convenience and lower maintenance win out.