Clinical Indications, Preoperative Assessment, Set-up and Organizational Aspects

Abstract

A totally implantable access port is indicated for long-term, repeated administration of medications, chemotherapy agents, and blood products; parenteral nutrition; frequent collection of blood samples; and when alternative access cannot easily be achieved. These ports have several advantages over external central venous catheters, including less frequent maintenance, less risk of infection and thrombosis, and greater acceptance by patients. Before insertion of a totally implantable access port, indications for its need, how it will be used, and the overall physical condition of the patient should be considered. A minor surgical procedure is required to insert the port, although no special training is needed. The surgery should be performed in an operating room or interventional radiology unit using maximum sterile barrier precautions and sterile technique. Fluoroscopy and/or ultrasonography are needed to identify an appropriate vessel for catheter insertion and to confirm the final position of the catheter.