Reliable, comfortable access to your bloodstream for chemotherapy, long-term medication, regular blood tests or nutrition, placed precisely under ultrasound and X-ray guidance, and looked after when problems arise.
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.
Using ultrasound, the vein is entered cleanly at the first attempt; using X-ray, the catheter tip is positioned exactly where it should sit. The procedure is done as a day case under local anaesthetic with light sedation. No general anaesthetic in most cases. 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. These problems are very treatable. 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. Where standard attempts fail, an interventional radiologist can usually still establish safe access: imaging finds a usable vein, and blocked central veins can sometimes be reopened (recanalised) to restore a route for treatment. Few problems are truly “no access” once IR is involved.
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.
Usually no. Most placements are done under local anaesthetic with light sedation as a day case, so you're comfortable but not under a general anaesthetic. 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.
Almost always. With ultrasound and X-ray guidance, an interventional radiologist can find a usable vein, and blocked central veins can sometimes be reopened to create a route. Difficult access is one of the situations where IR is most valuable.