To evaluate whether suture fixation of the Port-a-cath is correlated with a reduced incidence of port malposition. To describe the techniques in Port-a-cath insertion.

A Port-a-cath is a subcutaneously placed totally implantable device that allows long-term venous access. This is essential for many patients, especially those undergoing chemotherapy. It has almost completely replaced external catheters when ongoing intermittent venous access is required. The procedure is usually performed under local anesthetics. Under ultrasound guidance, the internal jugular vein or subclavian vein is accessed using Seldinger technique - a needle guide wire is passed through, followed by a dilator sheath introduction over the guide wire (fig.1) [1,2,4,6,7]. A pocket large enough...

A total of 93 Port-a-cath insertions were performed between these two interventional radiologists involved in the period of 01/01/2017 and 30/12/2019. 54 of these were fixated and 39 were not. Out of those that were, none malpositioned within the two month post-insertion period. In contrast, 1 out of the 39 non-fixated ports has ‘flipped’ 34 days post-insertion. Based on this result, the relative risk of malposition in non-sutured ports compared to sutured ports is 4.13, with a P value is 0.38 (confidence level of 95%)....

This audit has not been able to show whether suture fixation is essential in preventing port malposition. Future directions include increasing sample size and the number of interventional radiologists involved.

Busti AJ, MD, PharmD, FNLA, FAHA. Seldinger technique for intravenous line placement. Evidence-based medicine consult. Sept 2015. (https://www.ebmconsult.com/articles/seldinger-technique-intravenous-iv-placement) Harish K et al. Chemoport anchoring - the in situ technique. Surgical Techniques Development 2011; Volume 1:e9 Houston BL, Yan M. Spontaneous migration of an implanted central venous access device into the ipsilateral jugular vein. CMAJ July 12, 2016 188 (10) 752 Na H et al. Fixation methods for implantable port chamber: comparative study using glue, self-stabilizing leg and suture fixations in rabbits. Koran J Radiol. 2004;...