Understanding Where Is a Portacath Inserted

October 1, 2025 •

4 min read

For patients requiring frequent or long-term intravenous treatments, a Portacath is often a preferred option, with some devices capable of remaining in place for years. Understanding where is a Portacath inserted is crucial for patients as it determines the surgical site and subsequent care needed. This implantable port, designed to provide consistent, comfortable access to the bloodstream, is most commonly placed in the chest but can also be inserted in other locations.

Quick Summary

This article explains the common and alternative insertion sites for a Portacath, detailing the minor surgical procedure and the purpose behind placing it in specific large veins. It compares Portacaths to other central lines and discusses patient care.

Key Points

Primary Placement: A Portacath is most commonly inserted in the upper chest, typically on the right side, just below the collarbone.
Catheter Location: The catheter is threaded into a large central vein, such as the superior vena cava, which leads to the heart.
Alternative Sites: In some cases, a Portacath can be inserted in the upper arm or, less commonly, the abdomen.
Infection Control: The fully implanted nature of a Portacath, unlike external lines, contributes to a lower risk of infection.
Minimally Invasive: The insertion is a minor outpatient surgical procedure performed under local anesthesia, with the entire device housed beneath the skin.
Long-term Use: A Portacath is designed for long-term use, lasting months to years, which is particularly beneficial for ongoing treatments like chemotherapy.

Primary Insertion Site: The Chest

Most commonly, a Portacath is inserted in the upper chest, typically on the right side, just below the collarbone. The placement of the port's reservoir under the skin creates a small, raised bump that is easily palpable. The main reason for this location is proximity to a large, central vein, most often the superior vena cava. During the procedure, the catheter is threaded from the insertion point into this central vein, which provides a direct and efficient route to the heart for administering medications, fluids, or transfusions. Choosing the right side is generally preferred because it provides a more direct and safer path to the superior vena cava, though placement on the left side is also possible.

The chest placement offers several benefits, including discretion, as the device is entirely beneath the skin and requires no external tubing when not in use. This allows for a relatively normal daily routine, including showering, once the incision has healed. For many patients, especially those undergoing long-term treatments like chemotherapy, the reliability and convenience of a chest port significantly improve their quality of life by eliminating the need for repeated peripheral IV insertions.

Alternative Insertion Sites

While the chest is the standard location, a Portacath can be inserted in other areas, depending on patient anatomy, medical history, or the specific needs of the treatment. The most common alternative site is the upper arm. An arm port is placed in the inner side of the upper arm, with the catheter routed to the same central vein near the heart.

Another less common alternative is placement in the abdomen, which may be chosen in specific circumstances. The decision on which site to use is made by the healthcare provider in consultation with the patient, taking into account factors like the patient's lifestyle, comfort, and any previous surgical sites. For example, if a patient has undergone a mastectomy or has other chest-area medical issues, an arm or abdominal port might be a better choice.

The Portacath Insertion Procedure

The placement of a Portacath is a minor surgical procedure, typically performed on an outpatient basis under local anesthesia, though general anesthesia or sedation may be used. The entire process usually takes about an hour.

Step-by-step:

The patient is positioned comfortably, and the skin at the chosen insertion site (e.g., chest) is cleaned and sterilized.
Local anesthesia is administered to numb the area, and imaging guidance, such as ultrasound, is used to locate the vein.
A small incision is made at the base of the neck or near the collarbone to access the central vein.
A second, slightly larger incision is made lower on the chest or in the arm to create a subcutaneous pocket for the port reservoir.
The catheter is threaded through the vein, and its position is confirmed with a final X-ray image.
The catheter is connected to the port, and the incisions are closed with stitches or surgical glue.

After the procedure, the port site will be covered with a sterile dressing for a period of healing, and patients are given post-operative care instructions.

Portacath vs. Other Venous Access Devices

Choosing the right type of vascular access depends on the duration and nature of the treatment. The Portacath is a long-term solution, offering benefits not found in other devices like PICC lines or external central venous catheters (CVCs).


Feature	Portacath	PICC Line	CVC (External Tunneled)
Placement Site	Subcutaneous (chest or arm); catheter ends near heart	Inserted in peripheral arm vein; catheter ends near heart	Inserted in neck or chest; catheter ends near heart
Duration	Long-term, months to years	Short to medium-term, weeks to months	Short to medium-term, weeks to months
Appearance	Fully implanted, visible as a small bump	External catheter visible on the arm	External tubing visible on the chest or neck
Infection Risk	Low, as device is fully enclosed	Moderate, as there is an external exit site	Higher, due to external exit site
Daily Activities	Allows for swimming and normal bathing after healing	Requires careful management to keep site dry	Requires careful management to keep site dry
Insertion	Minor surgery under local anesthesia	Simpler procedure under local anesthesia	Minor surgery

Potential Risks and Management

While generally safe, Portacath insertion carries some minimal risks, including:

Infection: Vigilant care is needed to minimize the risk of infection at the insertion site.
Catheter Issues: Malpositioning, migration, or blockage of the catheter are rare but possible.
Blood Clots: There is a slight risk of blood clot formation in the vein, which may cause arm swelling.
Bruising and Tenderness: Bruising and soreness around the incision sites are normal for a few days post-procedure.

Proper care, including regular flushing when not in use and prompt reporting of any concerning symptoms like fever or swelling, is essential for managing these risks.

Conclusion

In summary, a Portacath is most often inserted in the upper right side of the chest to access a central vein, though alternative sites like the arm are possible. The specific placement is chosen based on patient and clinical factors to provide long-term, reliable venous access for various treatments, including chemotherapy. This minor surgical procedure offers significant benefits over other intravenous lines, including a reduced infection risk and greater patient comfort. Understanding where and how a Portacath is inserted is a vital part of preparing for and managing this effective medical device.

For more detailed information on Portacath placement, including preparation and recovery, you can refer to authoritative sources such as Memorial Sloan Kettering Cancer Center.

Frequently Asked Questions

No, while the chest is the most common site, a Portacath can also be inserted in the upper arm or, in specific medical circumstances, the abdomen.

The procedure is performed under local anesthesia, so you will not feel pain during insertion. You may experience some mild soreness or discomfort at the incision sites for a few days afterward, which can be managed with pain relief.

The insertion is a minor outpatient surgery, usually taking about an hour. It involves two small incisions—one to access the vein (e.g., in the neck) and another to place the port reservoir (e.g., in the chest or arm).

A Portacath is a long-term device and can remain in place for months or even years, depending on the patient's treatment needs. It can be removed when it is no longer required.

Once the incision site has fully healed, which takes about 1-2 weeks, you can shower and swim normally. When the port is being accessed with a needle, the area must be kept dry.

Portacaths are used for long-term or frequent treatments such as chemotherapy, long-term antibiotics, intravenous nutrition, and blood transfusions. They can also be used for blood draws.

A Portacath insertion is performed by a qualified medical professional, such as a surgeon or an interventional radiologist, often using ultrasound or X-ray guidance for accurate placement.