Patients undergoing chemotherapy often need safe, durable and long-term access to their bloodstream. Devices like chemoports, Hickman lines or PICC lines provide reliable entry points for treatment and blood tests. These are placed surgically under sterile conditions by a vascular surgeon to ensure safe and comfortable chemotherapy delivery.
Chemotherapy often requires repeated and prolonged access to the veins. Ordinary veins in the arms are not built to withstand frequent needle pricks or the chemical strength of chemotherapy drugs. Over time, they become scarred, hard to access and can collapse. To solve this problem, specially designed vascular access devices are placed into larger, deeper veins in the body that can handle the volume and duration of chemotherapy.
As vascular surgeons, we create secure, long-term vascular access through minor surgical procedures. This access is used not only for chemotherapy but also for drawing blood samples, administering antibiotics, nutritional support or other prolonged intravenous treatments.
There are three main types of long-term vascular access devices:
A chemoport is a small, round medical device implanted under the skin, usually on the upper chest. It connects to a thin tube (catheter) that is threaded into a large central vein near the heart. The port is placed entirely beneath the skin and is accessed using a special needle during each treatment.
How It Works:
The port lies just below the skin and creates a safe and durable entry point to the bloodstream. It is usually made of titanium or plastic and is completely hidden under the skin, leaving no open wound or external tubing. Once healed, it requires minimal maintenance between treatments.
Benefits of a Chemoport:
Surgical Procedure:
The port is implanted under local anesthesia through a small incision. The catheter is inserted into a central vein (usually the subclavian or jugular vein) and connected to the port, which is then fixed in place under the skin. The entire procedure takes about 30–45 minutes and is done as a day-care procedure in most cases.
Patients can resume normal activities within a couple of days. The site needs to be kept clean and dry and only trained professionals should access the port.
A Hickman line is a type of tunneled central catheter. Unlike the chemoport, the Hickman line exits the body through the chest wall and remains externally visible. It is also connected to a central vein near the heart and is used for frequent access to the bloodstream.
When Is It Used?
This is usually recommended when chemotherapy, antibiotics or blood transfusions are needed frequently and for long durations. It is ideal for patients who require regular blood draws or are not comfortable with repeated needle pricks.
Key Features:
Surgical Process:
The line is inserted through a small incision and tunneled under the skin before entering a central vein. The external part is secured with a dressing and the line is flushed regularly to prevent blockage. The procedure is done under local anesthesia with or without mild sedation.
While it requires more care than a chemoport, it is very effective for certain patient groups. Patients must be taught proper handling and infection prevention for home care.
A PICC line is a long, thin tube inserted into a vein in the upper arm and advanced until it reaches a central vein near the heart. It is less invasive than other options but is suitable for short to intermediate durations.
Ideal For:
Advantages:
However, PICC lines come with a higher risk of blockage and infection compared to ports or tunneled lines, especially if not maintained properly. Regular flushing and dressing changes are necessary.
Whichever vascular access device is used, proper care is essential to avoid complications such as infection, blockage or clot formation.
General Guidelines:
Our team provides detailed instructions to both patients and caregivers on how to manage these devices safely at home.
If you or a loved one is about to begin a prolonged course of chemotherapy, the oncologist may recommend long-term vascular access. This should ideally be done before chemotherapy starts to prevent unnecessary delay or complications from repeated cannulation.
A vascular surgeon will evaluate your veins, medical condition and treatment plan to choose the most suitable type of access. In some cases, imaging or ultrasound mapping may be used to ensure proper vein selection.
All procedures are performed under local anesthesia and are generally well tolerated. Mild soreness is expected for a day or two.
Yes, once the incision heals. Special care should be taken with external lines like Hickman or PICC lines. Ports allow for more normal activity as they are under the skin.
1) Chemoports can remain functional for years
2) Hickman lines can stay for several months if maintained well
3) PICC lines are suitable for weeks to a few months
Long-term vascular access is a crucial part of cancer care. These devices not only make chemotherapy smoother but also reduce discomfort and protect veins from damage. At our clinic, vascular access procedures are performed with surgical precision, ensuring safety, function and comfort for every patient.
If you have been advised chemotherapy or are planning prolonged treatment, consult us for timely and appropriate vascular access tailored to your needs.
