An implantable chamber made to support being pricked with a Huber needle 1,500 times.

The catheter port (implantable catheter port or ICP) allows chemotherapy medicines to be administered  without an injection in the arm.

It can also be used to take a blood sample or to inject medicines other than those for chemotherapy (long term antibiotic treatment).

The catheter port can also be used for parenteral nutrition.

Indications

• Chemotherapy
• Injection of antibiotics or antiviral drugs.
• Total parenteral nutrition (TPN)

Implanting an ICP or IVAD

Putting a catheter in place is carried out by a surgeon trained in this technique.

It takes place in an operating theatre in surgical asepsis conditions.

For certain patients it can be carried out under a local anaesthetic.

However, patient comfort is better using a general anaesthetic.

The surgery lasts, on average, 30 minutes.

A control chest x-ray ensures that the catheter is in the correct position, and the absence of immediate complications (pneumothorax).

The patient must stay a certain time in the recovery room.

The patient may leave if authorised by the surgeon and with the agreement of the anaesthetist doctor.

The stitches are removed at the control consultation on day 10.

Complications when implanting an ICP:

• Haematoma or Bruising at the level of the neck and/or following the trajectory of the catheter under the skin.
• Dyspnoea, shortness of breath, due to the presence of air in the pleura because of a collapsed lung, pneumothorax.
• It may be necessary to evacuate the pneumothorax, air or gas in the cavity between the lungs and the chest wall, by using a needle or a drain.
• Local infection with a fever and shivering.
• Thrombosis with swelling of the arm or neck.

Rinse abundantly before and after each treatment + heparinisation.

Managing the implantable catheter port:

Extravasation : 

Where the product  flows  from the vessel, or not into the vessel, and into the surrounding area. Possible necrotic reaction, particularly if during chemotherapy. 

Immediately use aspiration and suction equipment at the injection point. This is a therapeutic emergency.

Inversion of the implantable port:

Use local anaesthetic to reposition the box.

Implantable port blocked by a blood clot: 

Urokinase protocol (surgical consultation).

Late infection caused by the IPC:

• Local signs are inconsistent (fever, and inflammation around the chamber).
• An increase in temperature is often observed, even 20 minutes after the injection of an antibiotic.
• The choice of antibiotic depends on the comparative blood cultures made, to identify the germ in the IPC, but also around it to see if the infection is general or local,
• Antibiotic therapy is necessary for 2 weeks, but in 65% of cases the IPC must be removed.