Portacath/Ports. Which companies/types are the best?

[just_thispage]

I am a patient, but I figured if anyone would know which ports work and which are a pain and break, it would be the infusion nurses. I am getting a port soon and was told I can choose the company (Bard etc.) and type of port (slimline vs. normal etc.)

Does anyone know of information or recommend one portacath company over another?

I looked up Bard powerport and it looks like they've had a lot of problems with people getting catheter separation.

Then I looked up Angiodynamics and there arn't a ton of reports, however there are a few about the port disintegrating, one of it eroding through the skin, and a bunch of websites talking about how the company is not doing well financially.

My second question is regarding how the ports are placed...left side vs. right side, and subclavian vs. with the catheter going up over the collarbone. Does anyone know if one way is safer or more comfortable than the other?

My surgeon plans to use subclavian approach and I'm a bit concerned about pinch off syndrome. However he didn't have any statistics on how often that happens. With the issues with disintegration or separation for both companies' ports, pinch off syndrome is a concern of mine.

Lastly, does a powerport relate only to the fact that it can have contrast put in it or does it also relate to what types of medications can be put in it/how fast the infusion can be done? I read one patient post that said powerports are thicker, and I also read on here that nurses have had trouble with bard powerports not drawing blood and just being difficult all around. I have to have blood drawn every 2 weeks, and infusions 5 days a week.

Any help or advice would be so appreciated. Thank you so much!!!!

[IVRUS, BSN, RN]

Personnally, If I were getting one I would ask for a Bard Groshong Inplanted Port. For these reasons:

1. The have been around for a long time.

2. They require flushing with only Normal Saline, thus Heparinization is not needed and one can avoid HIT (heparin Induced Thrombocytopenia)

3. From personal experience, I have never had to use Cathfo, which will open up a clogged central line or one with just a withdrawl occlusion, on a Groshong Port.

A power port means that if you are really sick and they need to use a CT scan with the power injector for visualization purposes, then they can access your port with a special non-coring needle and then they are able to complete this test. Power ports can withstand up to 300 psi's. If you need these spiral CT's, get a power port, if not, then a normal implanted port can be used. Some of the power ports have raised 'bumps" on them which in sick, emmaciated persons have been problematic as these elevations have eroded through the pt's skin.

Placement on either side may be physician preferance, or may be dictated by pt's condition or the presence of other things like a pacemaker or ICD or venous malformation. Some MD's prefer the right side for placement secondary to its direct route to the SVC.

Make sure that the nurses always access your port per sterile technique. After awhile, scar tissue will buildup and the discomfort with accessing will lessen. There are also topical creams that they can use on top of your port especially in its infancy that will numb the area before its accessed.

I hope this answers your questions. Feel free to PM me if you'd like to ask me anything else.

[iluvivt, BSN, RN]

Agree with IVRUS. I would also go with a BARD product and if you do not need to have frequent CT scans requiring contrast there is really no need to have a power port placed. BARD has a very good track record with their ports. Once a power port is placed and after the catheter has been attached to the portal chamber the surgeon slides on this locking mechanism that locks the catheter to the portal chamber. When I saw it I thought how easy it would be to slide it on backwards and thus not locking it and just securing it and I am wondering now if that could be the cause of portal separation. It could also be related to a power injection being administered without a proper assessment of the patency of the port. Overall I have seen less complications on the right side. The most important thing is to protect your port... make sure that any health care professional accessing your port and working with it is experienced with ports. make certain they wash/cleanse their hands and once accessed scrub all ports prior to use or if left accessed and if they have it an alcohol impregnated cover, such as a curos on the needleless connector. It is OK for you to protect your access and ask questions and it sounds like you will be that kind of patient..my favorite kind.