From the Guidelines
Ports are the preferred choice for central venous access due to their lower rates of catheter-related bloodstream infections (CRBSI) and improved patient satisfaction compared to PICC lines. The advantages of ports over PICC lines include:
- Lower reported rates of CRBSI, with ports having the lowest rates compared to tunneled or non-tunneled CVCs, including PICC lines 1
- Reduced access-related anxiety and pain, with a study showing that 27% of patients with standard peripheral venous access ultimately required CV access, highlighting the benefits of ports in reducing complications and improving patient experience 1
- Preservation of peripheral veins, less nursing time spent attempting to gain vascular access, shorter hospital stays, and decreased infusion therapy costs 1
- Single lumen ports are suitable for patients with solid tumors receiving long-term intermittent bolus chemotherapy, while double lumen ports may be required for patients who need regular blood transfusions or bone marrow transplantation 1
- Port implantation in brachial veins is associated with easy vascular access and a lower risk of complications at insertion, making them a preferable option for patients with tracheostomy, head and neck tumors, and anatomic deformities in the chest 1
- A systematic review and meta-analysis showed a 3- to 4-fold increased risk of infections, noninfections complications, and device removal with PICC lines compared to implantable ports, highlighting the superiority of ports in terms of safety and efficacy 1
From the Research
Advantages of a Port versus a PICC Line
The advantages of a port versus a PICC line can be summarized as follows:
- Lower incidence of total complications, thrombosis, deep vein thrombosis, implantation failure, unplanned catheter removal, and local reactions 2
- Better complication-free survival 2
- Smaller decline in global health status post-implantation compared to the PICC group 2
- Potential for safer and more comfortable intravenous catheterization option for cancer patients undergoing chemotherapy 2
- Lower risk of complications when used in a specialty ward, as opposed to a non-specialty ward 3
- Ability to maintain the venous access without compromising the patient's health in case of catheter infections 4
- Similar clinical results as traditional long-term vascular access devices, such as PICC and arm totally implantable vascular access device, in breast cancer patients 5
Cost-Effectiveness
In terms of cost-effectiveness, the advantages of a port versus a PICC line include:
- Higher cost per catheter day, but similar total cost when considering catheter days 2
- Potential for higher total cost, but lower cost per catheter day when considering the cost-effectiveness of PICCs and PORTs for medium- to long-term chemotherapy 6
- More cost-effective than PICCs for 9-12 month dwell times, but less cost-effective for 3-9 month dwell times 6
Patient Outcomes
The advantages of a port versus a PICC line in terms of patient outcomes include:
- Similar global health status between the two groups during the post-implantation, mid-treatment, and end-treatment periods 2
- Potential for improved quality of life assessments, as measured by the EORTC QLQ-C30, in the IPC group compared to the PICC group 2
- Lower incidence of upper extremity deep vein thrombosis, reservoir pocket infection, and other complications in breast cancer patients undergoing chemotherapy 5