What is placement of a subclavian venous infusion catheter
with an implantable port?
Placement of a subclavian venous infusion catheter with an
implantable port is a procedure for putting a catheter into
the subclavian vein. The subclavian vein is a large vein in
the upper part of the chest under the collarbone. The
catheter is a thin, soft plastic tube. One end is tunneled
under the skin away from the vein to another site just under
the skin. The end of the catheter has a reservoir, or port,
into which drugs can be injected. The reservoir is a
storage space for fluids.
When is it used?
This procedure allows you to get intravenous (IV) drugs
without having a needle in your vein.
Examples of alternatives are:
- having the drugs put into a smaller arm vein that is
close to the surface of your skin
- having a catheter with the IV line coming out of the skin
(an external lumen) (This option would lead to a greater
risk of infection.)
- choosing not to have the procedure.
You should ask your health care provider about these
choices.
How do I prepare for the procedure?
Plan for your care and recovery after the operation,
especially if you are to have general anesthesia. Find
someone to drive you home after the surgery.
Follow your health care provider's instructions about not
smoking before and after the procedure. Smokers heal more
slowly after surgery. They are also more likely to have
breathing problems during surgery. For this reason, if you
are a smoker, you should quit at least 2 weeks before the
procedure. It is best to quit 6 to 8 weeks before surgery.
Also, your wounds will heal much better if you do not smoke
after the surgery.
Follow any other instructions your provider gives you.
If you are to have general anesthesia, eat a light meal,
such as soup or salad, the night before the procedure. Do
not eat or drink anything after midnight and the morning
before the procedure. Do not even drink coffee, tea, or
water.
What happens during the procedure?
You will be given a local or a general anesthetic to keep
you from feeling pain. A general anesthetic will put you to
sleep.
Your provider will make a small cut in your upper chest.
Your provider will place one end of the catheter into the
vein under your collarbone and tunnel the other end under
the skin away from the puncture site. A port will be placed
under the skin through another small cut. Your provider
will attach the catheter to the port and sew the cuts
closed.
What happens after the procedure?
You will have a chest x-ray to check the position of the
catheter and to check your lungs.
You will be watched for a few hours while you recover from
the anesthetic, and then you may go home. You should avoid
strenuous activity for a day. You will have a dressing over
the cut for a few days.
You will need to have the catheter for as long as you need
injections of medicine.
Ask what other steps you should take and when you should
come back for a checkup.
What are the benefits of this procedure?
You will avoid the pain and discomfort of having to have
medicine injected into a vein. You can also avoid damage to
your veins by needles and strong medicines.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia.
Discuss these risks with your health care provider.
- The local anesthesia may not numb the area quite enough
and you may feel some minor discomfort. Also, in rare
cases, you may have an allergic reaction to the drug used
in this type of anesthesia. Local anesthesia is
considered safer than general anesthesia.
- When the catheter is inserted into the vein in your
chest, the lining of the lung could be punctured. This
could cause the lung to collapse. A collapsed lung would
require another procedure under local anesthetic to
reexpand the lung.
- As long as the catheter is in place, it may become
infected. In that case, the catheter and the port
would have to be removed.
- A clot may form around the tip of the catheter in the
vein and block it.
You should ask your health care provider how these risks
apply to you.
When should I call the health care provider?
Call your provider right away if:
- You develop a fever.
- You become short of breath.
- You develop a red, swollen, or tender area around the
implanted reservoir.
Call your provider during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2005 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.