People having chemotherapy often need safe, long-term access to a vein. A chemoport, Hickman line or PICC line gives a reliable route for treatment and blood tests. A vascular surgeon places these under sterile conditions so chemotherapy can be given safely and comfortably.
Medically reviewed by Dr. Aniruddha Bhuiyan, MCh vascular surgeon. Updated October 2026.
Chemotherapy usually means getting into a vein again and again, often for months. The small veins in the arm cannot cope with frequent needle pricks or strong chemotherapy drugs. Over time they scar, become hard to find and can collapse. To get around this, the surgeon places a special device, such as a chemoport, in a larger, deeper vein that can cope with the amount of drug and the length of treatment.
As vascular surgeons, we set up safe, long-term access through minor surgery. Besides chemotherapy, the team can use this access to take blood samples, give antibiotics, provide nutrition through a drip or give other long-term treatments into the vein.
There are three main types of long-term vascular access devices:
A chemoport is a small, round device placed under the skin, usually on the upper chest. It connects to a thin tube (catheter) that runs into a large central vein near the heart. The whole port sits under the skin, and the nurse reaches it with a special needle at each treatment.
How it works:
Because the port sits just under the skin, it gives a safe entry point into the bloodstream that lasts. Most ports are titanium or plastic, and they stay completely hidden, with no open wound or tube outside the body. Once the wound has healed, it needs very little care between treatments. Macmillan Cancer Support also explains how implantable ports work.
Benefits of a chemoport:
The procedure:
The surgeon puts the port in under local anaesthesia through a small cut. The catheter goes into a central vein, usually the subclavian or jugular vein. The surgeon then connects it to the port and fixes the port in place under the skin. The procedure takes about 30 to 45 minutes and, in most cases, you go home the same day.
Most patients are back to normal activities within a couple of days. Keep the site clean and dry, and let only trained staff use the port.
A Hickman line is a type of tunneled central catheter. Unlike a chemoport, it comes out through the skin of the chest, so you can see it. It also connects to a central vein near the heart, and doctors use it when they need to reach the bloodstream often.
When is it used?
Doctors usually advise it when a patient needs chemotherapy, antibiotics or blood transfusions often and over a long period. It suits patients who need regular blood tests or who find repeated needle pricks hard to bear.
Main features:
How it goes in:
The line goes in through a small cut and runs under the skin for a short distance before it enters a central vein. A dressing covers the outside part, and the nurse flushes the line regularly so it does not block. The surgeon does this under local anaesthesia, with or without mild sedation.
It needs more care than a chemoport, but it works very well for certain patients. Patients are taught how to handle the line and prevent infection at home.
A PICC line is a long, thin tube put into a vein in the upper arm and passed along until its tip reaches a central vein near the heart. It is less invasive than the other options, but it is meant for short to medium periods.
Best suited for:
Advantages:
PICC lines tend to have more problems than ports, such as blockage, clots in the arm vein and infection, more so without good care. They need regular flushing and dressing changes.
Whatever the device, it needs proper care to avoid infection, blockage or clots.
General guidelines:
We give patients and their caregivers clear instructions on how to look after these devices safely at home.
If you or someone in your family is about to start a long course of chemotherapy, the oncologist may suggest long-term vascular access. It is best done before chemotherapy begins, to avoid delays and the problems that come from repeated cannula insertions.
A vascular surgeon will look at your veins, your general health and your treatment plan to choose the right type of access. Sometimes the surgeon maps the veins with ultrasound first to pick the best vein.
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 an important part of cancer care. It makes chemotherapy easier, cuts down discomfort and protects the veins from damage. At our clinic these procedures are done with care, so that the device is safe, works well and is comfortable for every patient.
If you have been advised chemotherapy or a long course of treatment through the vein, see us early so the right access device can be placed in time.
