Central venous access device (CVAD) insertion (ports)

You may need to have a surgical procedure to insert or remove a central venous access device (CVAD). A venous access device is often implanted in the upper chest or the arm. Examples include a single lumen Hickman^® catheter or a Port-a-Cath (also called a line or a port). This allows easy access to a vein for the many injections needed to manage hemophilia.

These procedures are common for people with inhibitors. However, they are still surgeries. Bleed control before, during, and after surgery is important.
The port is a small metal or plastic reservoir with a rubber diaphragm. This is connected to a catheter. The whole device is surgically implanted under the skin. The catheter is then threaded into a large vein in the chest or arm. Injections are given by inserting a special needle through the skin and into the rubber diaphragm. The fluid then flows through the catheter into the vein.

Risks and benefits of ports

A port makes giving frequent injections easier. It eliminates the problem of finding a vein. However, there are risks, including infection or blood clots. Infections occur in about half of people using a port after about 5 years. The rate of infection is higher in people with an inhibitor. The risk of infection also increases with the length of time the port remains in place. It is recommended that the port be used for a few years at most. Using careful sterile techniques for injections may reduce the chance of infection. It helps if your doctor monitors the device. You and your doctor should weigh the risks and benefits of using a port.

Adequate blood clotting therapy is essential during implantation or removal of a port. For people with inhibitors, this usually means a bypassing agent. Learn more


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