Venous Vascular Access
Patients on chemotherapy, long courses of antibiotics or intravenous nutrition need reliable venous access that does not depend on finding a vein every time. Placing these devices under ultrasound and X-ray guidance means the vein is seen directly, the tip is positioned correctly first time, and the complications associated with blind insertion are largely avoided.
Dr. Mohamed El Ghobashy · Consultant Interventional Radiologist
What it treats
- •Chemotherapy requiring a totally implanted port under the skin
- •Long courses of intravenous antibiotics or antifungals
- •Total parenteral nutrition (intravenous feeding)
- •Repeated blood sampling or transfusions in patients with difficult veins
- •Tunnelled catheters for dialysis or apheresis
Who is a candidate?
- Patients starting a treatment course expected to last weeks or months
- Patients whose peripheral veins are exhausted or repeatedly failing
- Patients receiving drugs that damage small veins if given peripherally
- Referral usually comes from the oncology, haematology or nutrition team
How the procedure works
- 1
Planning
The side and vein are chosen with ultrasound, taking into account previous lines, planned surgery, and which arm you use.
- 2
Puncture under ultrasound
Local anaesthetic is given and the vein is punctured under direct ultrasound vision — the vein is seen throughout rather than located blindly.
- 3
Placement
For a port, a small pocket is created under the skin of the chest and the catheter is tunnelled to the vein. For a PICC, the catheter is advanced from an arm vein. X-ray confirms the tip sits at the correct level.
- 4
Check and use
The device is flushed, the position documented, and a port can generally be used the same or the next day.
Recovery
A port site is tender for a few days and the small wound is kept dry until it heals. Once healed, a port sits entirely under the skin — you can shower and swim normally — and it is flushed periodically when not in use. A PICC has an external portion that needs a dressing and regular care, which the nursing team will teach.
Discuss this procedure
Private consultations and procedures are at Andalusia Hospitals, Maadi. Kasr Al-Ainy is Dr. El Ghobashy's academic post at Cairo University and does not take private cases.
Frequently asked questions
Should I have a port or a PICC?
Broadly: a port is fully implanted, better for long treatment courses over months, and far less restrictive day to day. A PICC is quicker to place and remove and suits shorter courses. The choice depends on how long treatment will last and what is being given.
Will people see it?
A port is entirely under the skin. There is a small scar and a soft bump under the skin of the upper chest, but nothing protruding and no external tube.
How long can it stay in?
Ports can remain for years while treatment continues, as long as they are flushed on schedule and stay free of infection. They are removed once they are no longer needed.
Other procedures
This page is general information, not medical advice for an individual. Whether a procedure suits you depends on your imaging, your history and an in-person assessment.