Venous Access Procedures
People with some medical conditions require frequent intravenous (IV) antibiotic treatment, chemotherapy, intravenous feeding, or blood transfusions over an extended period of time. To spare these patients the stress and pain of repeated needle sticks, interventional radiologists can implant a venous access device, a very thin flexible tube called a catheter, into a vein in the trunk. In some devices one end of the catheter remains outside the skin, and medications are administered and blood is drawn there. In a device called a port, the access point, a small raised disk, is completely below the skin, and doctors insert a tiny needle through the skin above the disk to draw blood or deliver medication. All of these devices can remain in place either temporarily (days) or longer-term (weeks to years).
How do I get ready for the procedure?
On the night before the procedure eat a light meal, then do not eat or drink anything after midnight. We will provide you with more detailed information about which medications you may take in days before and on the morning of the procedure. Plan to have someone drive you home after the procedure.
What will happen during the procedure?
After you arrive at the interventional radiology suite and change into a gown, you will lie face up on the procedure table. To relax you and block any pain we will intravenously give you a combination of medicines called “conscious sedation.” We will use X-ray and/or ultrasound image guidance to identify the vein where we will position the catheter, and after making a small incision, we will advance the catheter to that location through a vein in the arm, neck, or groin. For some types of catheters we will make a second incision, and create a tunnel or pocket below the skin for the device. If your device emerges from the skin we will place stitches, tape, or surgical glue to fix it in place. We may perform an X-ray after the procedure to ensure the catheter is positioned correctly. Your venous access device is then ready to be used.
Are there any risks?
After catheter or port placement some people develop bruising or swelling at the site of insertion. Pain medicine may relieve your pain until it subsides.
After the procedure
After the procedure we will have you rest in the recovery area, and you should continue to rest after you return home. You can resume your usual activities the following day; avoid lifting heavy objects, though. We will give you additional instructions before you leave the IR suite. When you no longer need your venous access device, we will remove it using a very simple procedure that does not require image guidance.