Peripherally Inserted Central Catheters (PICCs) and implantable ports (PORTs) are two primary types of central venous access devices used in oncology to facilitate the safe and effective administration of chemotherapy and other intravenous therapies. Each device has distinct roles, advantages and considerations in the management of cancer patients.
PICCs: Key Functions and Benefits
- Long-Term, Reliable Access: PICC lines are inserted into a peripheral vein in the upper arm and advanced to a central vein near the heart, allowing for long-term intravenous access often remaining in place for weeks to months.
- Direct Medication Delivery: They enable the direct infusion of chemotherapy, antibiotics, fluids and parenteral nutrition, reducing the need for repeated needle sticks and minimizing trauma to peripheral veins.
- Ease of Placement and Removal: PICCs are typically inserted at the bedside or in outpatient settings by trained nursing staff using ultrasound guidance, making the procedure less invasive and more cost-effective than surgical options.
- Home-Based Care: Their design allows patients to receive ongoing treatment at home, reducing hospital stays and improving quality of life.
- Blood Sampling: PICCs facilitate frequent blood draws, which is essential for monitoring during chemotherapy.
Potential Risks:
- Higher rates of catheter related thrombosis and bloodstream infections compared to ports, especially in inpatient settings.
- Require weekly maintenance and are generally easier to remove in case of complications.
Ports: Key Functions and Benefits
- Implantable, Subcutaneous Device: Ports are surgically implanted under the skin, usually in the chest with a catheter tip residing in a central vein. Access is gained by puncturing the port through the skin with a special needle.
- Long-Term and Durable: Designed for patients needing months or years of intermittent intravenous therapy, ports offer reliable, long-term access with minimal interference in daily activities.
- Reduced Maintenance: Require less frequent maintenance, typically monthly flushes, making them convenient for long-term use.
- Lower Complication Rates: Ports are associated with lower rates of overall adverse effects, including thrombosis and infection, compared to PICCs.
- Improved Quality of Life: Their subcutaneous placement reduces visible lines and restrictions, allowing greater freedom of movement and improved body image.
Potential Risks:
- Require a minor surgical procedure for implantation and removal.
- Access requires needle puncture through the skin for each use.
- Higher upfront costs compared to PICCs.
Clinical Decision Making:
- PICCs: are often chosen for patients requiring intermediate-term access, those with difficult peripheral veins or when ease of insertion and removal is a priority.
- Ports: are preferred for patients needing long-term, intermittent therapy, especially when minimizing infection and thrombosis risk is critical or when cosmetic and lifestyle considerations are important.
Both PICCs and Ports are integral to modern oncology care, providing essential vascular access for chemotherapy and supportive treatments. The choice between them depends on the expected duration of therapy, patient comorbidities, risk factors for complications, lifestyle needs, and institutional protocols. Ports generally offer a superior safety profile for long term use, while PICCs provide flexibility, ease of placement and are well suited for shorter treatment durations or when rapid removal may be necessary.
Explore our range of PICC Lines and Ports customized to meet your unique requirements with a variety of configurations. Designed to satisfy the needs of both medical professionals and patients, our vascular access devices stand out as the best option. Please contact us today for more information and a custom quotation.
References
Nickel, B. et al., (2024, January/ February) Infusion Therapy Standards of Practice 9th edition. Journal of Infusion Nursing. https://www.ins1.org/publications/infusion-therapy-standards-of-practice/
Lin, L. et al., (2023, July 14) Peripherally inserted central catheters versus implantable port catheters for cancer patients: a meta-analysis. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC10380996/
Teichgraber, U. et al., (2011, March 4) Central Venous Port Systems as an Integral Part of Chemotherapy. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC3063378/
Sapkota, S. et al., (2020, October 9). Analysis of Peripherally Inserted Central Catheter Line in Cancer Patients: A Single-Center Experience. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/34141688/