During and after your procedure

Preparing for the procedure

You will need to have a blood test to measure your full blood count (FBC) and clotting before the procedure. Your doctor or nurse specialist will tell you how to book your blood test when they recommend a Port-a-Cath.

If you are currently receiving chemotherapy, you will need the blood test to be taken within 1 week before the procedure.

If you are not currently receiving chemotherapy, a blood test within the 8 weeks before the procedure is fine. If you have had a blood test for any other reason within this time we can use the results.

Pre-assessment appointment

You will be asked to come for a pre-assessment appointment, this is usually 1 to 2 weeks before your procedure. At this appointment, you will be given advice on medicines and what you need to do before your procedure.

Changes to your medicines

At your pre-assessment appointment, you should tell your doctor or nurse if you:

• are taking any blood thinning medicines, such as antiplatelet medicines (for example aspirin or clopidogrel) or anticoagulant medicines (for example warfarin or rivaroxaban)
• have diabetes, as you may need to change the dose of your diabetes. This is because you will need to fast before the procedure

If you have coronary stents or metal heart valves in place, do not stop taking these medicines, but let the interventional radiology department know before coming to the hospital for your procedure.

If you need advice, call the interventional radiology department as soon as you get your appointment letter. Phone: 020 7188 5576 (for Guy’s Hospital), or phone: 020 7188 5479 (for St Thomas’ Hospital).

Fasting instructions

Do not eat anything for 6 hours before the procedure. However, you can drink still (non-fizzy) water up to 2 hours before the procedure. Eating and drinking before your procedure will cause delays.

On the day of the procedure

You will need to arrive 1 hour before your appointment time to allow enough time for preparation. 

You should arrange for a responsible adult to take you home by car or taxi after your procedure. We do not recommend that you use public transport as it is unsafe if you feel unwell.

Arrange for someone to stay with you for 24 hours after your procedure. If you cannot arrange this, please let us know as soon as possible.  

Before the procedure

After you have arrived at the interventional radiology department, you will be examined and assessed by a radiology nurse and given a hospital gown to wear.

A small, plastic tube (cannula) will be inserted into a vein in your arm. This means that we can give you sedation medicine (to help you relax) during the procedure, if you need it.  

You will able to ask the radiologist (a doctor who uses X-rays to diagnose and treat illnesses) any questions you have.

You will also need to sign a consent form before the procedure can take place to say that you understand what it involves.

During the procedure

You will be asked to lie on a X-ray table. The area where we will insert the Port-a-Cath will be cleaned and covered with sterile towels. 

The radiologist will inject some local anaesthetic into your skin on your chest and neck to numb the area. This may sting a little as it goes in. After this you should only feel pressure, and you should not feel any pain.  Please let the nurse know if you are uncomfortable.

The radiologist will make 2 cuts in the skin. The catheter will be inserted into the vein in your chest through one of these cuts. It will then be tunnelled under the skin to the second cut. The catheter is then connected to the port, which is inserted in the skin through the second cut, and fitted into a space created under the skin. We will check the position of the catheter and port with the X-ray machine. If it is in the correct position, the cuts are then stitched and dressing is put over the wound. 

Pain during the procedure

The local anaesthetic injection will sting for a moment, but the examination should not be painful. You might feel pressure where the doctor is working. If you have any pain during the procedure, please tell the nurse so pain relief can be given to you.

Once the local anaesthetic wears off you might have some pain or discomfort. Pain medicines, such as paracetamol can be taken to ease the discomfort. Always follow the instructions on the packet. 

After the procedure

After the Port-a-Cath has been inserted, you will stay in interventional radiology recovery for 2 to 4 hours.

Your blood pressure and pulse will be checked frequently at first, and then at regular times after. A clip on your finger will check the oxygen level in your blood. This is not painful.

We will provide light refreshments, such as tea or coffee, a sandwich and some fruit.  If you have any special dietary requirements, you are welcome to bring food and drink with you. 

The nurse will tell you when you can get up and move around. You will have a dressing on the port site and on the base of your neck. You will need to change these after 48 hours.

Ideally the Port-a-Cath wound site should remain covered with the waterproof dressing for 14 days. Avoid soaking the dressing for long periods of time as it may peel off. Short showers should not cause a problem.

When the Port-a-Cath can be used

The Port-a-Cath can be used as soon as it is inserted. Before it is used, the skin will be cleaned. A needle is then pushed through the skin into the port. Treatment is then given through this needle into the Port-a-Cath. The treatment goes into the port and flows into the catheter and your bloodstream.

Looking after the Port-a-Cath

The Port-a-Cath requires very little maintenance. After about 14 days (2 weeks) the wound site and skin should have healed. The Port-a-Cath is not visible to the outside, but a small bump might be felt where the port was inserted.

You can have a shower, bathe or swim.

Flushing the Port-a-Cath 

Your Port-a-Cath needs flushing to prevent it from becoming blocked. It should be be flushed once once every 4 weeks when it's not in use. If you come in for treatment more frequently than 4 weeks, it will be flushed during these times.

If your appointments are less frequent, you will need to see the nurse or doctor looking after you in clinic to have it flushed.

What to do if there’s a problem