Image-guided placement and management of ports, PICCs and tunnelled central venous catheters for chemotherapy and other long-term treatment.
Some treatments need repeated, reliable access to a large vein, chemotherapy, long courses of intravenous antibiotics or other medication, frequent blood sampling, intravenous nutrition (TPN) or apheresis. Repeated cannulas in small arm veins become painful and unreliable, and some drugs must be given into a large central vein. A central venous access device solves this. As an interventional radiologist, Dr Tarr places and manages these devices using real-time imaging, which makes the procedure safer, faster and more comfortable.
Ultrasound is used to access the vein directly, and X-ray guidance confirms catheter-tip position. The procedure is done as a day case under local anaesthetic with light sedation. General anaesthesia is available where clinically appropriate. Imaging guidance markedly reduces the risk of complications such as a collapsed lung or arterial puncture compared with landmark-only techniques.
When your treatment is complete, the device is removed in a short, straightforward procedure under local anaesthetic, and the small site heals quickly. Dr Tarr coordinates timing with your treating oncologist or haematologist.
Ports and lines sometimes stop working. They may not flush or draw back, the tip may sit in the wrong place, a fibrin sheath or clot may form, or there may be concern about infection. Many of these problems can be assessed and treated under imaging guidance. Under imaging, Dr Tarr can confirm what's wrong (a contrast study through the device), reposition a malpositioned line, clear a blockage or fibrin sheath, and advise on whether a device can be salvaged or should be exchanged, often keeping your treatment on schedule.
Some patients have no easy veins left after many treatments, multiple previous lines, or narrowing or blockage of the central veins. When standard venous access is difficult, IR can often identify alternative routes or, in selected cases, recanalise occluded central veins to restore a route for treatment.
It depends on how long you'll need treatment and your lifestyle. A port is hidden under the skin, low-maintenance and well suited to ongoing chemotherapy over months; a PICC is simpler to remove and suits shorter courses. Dr Tarr and your oncology team will recommend the best fit for your treatment plan.
Most placements are done under local anaesthetic with light sedation as a day case. General anaesthesia can be used when clinically appropriate. You can normally go home the same day.
Often, yes. Under imaging we can find out why (a clot, fibrin sheath or malpositioned tip), clear a blockage, or reposition the line, frequently saving the device and keeping your treatment on track. If it does need replacing, that can usually be done in the same visit.
In many cases, yes. With ultrasound and X-ray guidance, an interventional radiologist can identify alternative venous routes, and blocked central veins can sometimes be reopened to create a route for treatment.