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Surgically implanted infusion ports are placed below the clavicle (infraclavicular fossa), with the catheter threaded into the heart (right atrium) through a large vein. Once implanted, the port is accessed via noncoring "Huber" needles inserted through the skin. The health care provider may need to use topical anesthetic before accessing the port.
The port access site is fixed at 5 cm below the midline of the clavicle and 9 to 10 cm lateral to the midline of the chest. Then, a 5 to 6 cm incision is made to create a subcutaneous tissue pouch for the placement of port access site. A tunnel is made from the port access site until adjacent to the internal jugular neck wound.
Midline access is a type of peripheral venous access inserted into peripheral veins and that extends further than standard peripheral catheters but does not yet reach the large central veins of the thorax. They are used when intermediate-term access (one month) is needed or when administering medications that are highly irritating to smaller veins.
An implanted central venous catheter, also called a port a "cath" or "port-a-cath", is similar to a tunneled catheter, but is left entirely under the skin and is accessible via a port. Medicines are injected through the skin into the catheter. Some implanted ports contain a small reservoir that can be refilled in the same way.
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Hickman lines may remain in place for extended periods and are used when long-term intravenous access is required. Long-term venous catheters became available in 1968, and the design was improved by Dr. John W. Broviac (b. 1942), a nephrologist based in East Lansing, Michigan , in 1973.