FAQ

Anokryo®

SFN®- Portneedles

PORT CATHETER SYSTEMS

Portsysteme: APH

Yes ANOKRYO® can be used during these periods without any problems. As opposed to other gel and ointment preparations, there are no side effects.

Depending on symptoms approx. 3-4 x daily.

ANOKRYO® combines two therapeutic principles: dilatation and low temperature application.

This is not a problem. The important thing is that the ANOKRYO® rod be stored in the freezer. Normal refrigerator temperatures are insufficient.

No! Due to its water solubility it would freeze. The gel is applied prior to use.

No there are no adverse effects (see IFU).

Yes without any problems. Anokryo is also helpful in treating constipation

ANOKRYO® is available in the pharmacy or may be ordered there on a non-prescription basis. You may order it at this internet site.

You can reorder the gel from the pharmacy (PZN 07470157) or directly from us here on this website. (Note: No ointment or Vaseline! (Impedes the cold effect)
The product may be used for approx. 3 years.
In this case any other plastic container can be used to store the product.
No. ANOKRYO® is sold over the counter in pharmacies and does not require a prescription.
It is an effective medical aid having no adverse effects.
There are no restrictions concerning frequency of applications.
No, cleaning with basic domestic soap suffices.

You can purchase the product at this internet website. Modes of payment are explained at the site.

ANOKRYO® -combi-set: PZN 03941536.
ANOKRYO® -gel: PZN 07470157.

Yes the instructions for usage have been translated in various languages.

No. There is only one production size.

The rod is made of tissue compatible plastic.

Relief is felt almost immediately when the cooling effect sets in.
No the rod is stored in the container and is placed in the freezer.
Optimal temperature is reached after 2 hours.
No. Initially there may be some minor discomfort due to the cold temperature. Some mild pain may be felt in cases of anal fissure when the sphincter muscle is dilated.
A single treatment lasts 5- 10 minutes.
No. Vaseline in particular should not be used nor should any other ointments be applied.
You can prevent it by eating a diet rich in fibre, drinking enough, getting plenty of exercise and having regular bowel movements.
To pierce the port catheter system, the doctor needs needles with a special cut.
Only these special cannulas prevent the silicone membrane from being perforated and punched out.
We recommend the SFN® port cannulas, which are available in different stitch lengths and diameters, depending on, for example, the administration of medication, the patient’s anatomy and the place and type of application.

Puncture of the port system requires the use of a special needle with a bevelled tip. These needles are the only way to avoid punching defects on the silicone membrane. The needles are available in different lengths and bore diameters depending on which substances are to be injected.

The port needle is used to puncture the port chamber. The needle tip pierces a silicone membrane of the port.

Only port needles have a special needle tip. Only with these needles can punching defects on the silicone membrane be avoided.

It is doubly safe as it has a special safety system designed to prevent needlestick injuries.

The operator will find all details about the safety system in the respective instruction manual.

Yes, but we recommend our 100% guaranteed punch-free needles.

SFN stands for “punch-free needle”.

A “Huber” cannula (named after the inventor) is a commonly used port needle for accessing the port.

The tip is different from PakuMed’s SFN port needle.

The choice of size depends, among other things, on the patient’s anatomy, the location and type of application and is the decision of the doctor.

The port cannula is for single use and can remain in the port for up to 48 hours (recommended). Thus, this can be used to administer medicines and fluids, such as artificial food, over a longer period of time.

Example of a procedure:
The patient can sit or lie down comfortably.
The piercing is done under germ-free conditions (sterile) so that the port system retains its function for a long time and does not become infected.
The patient should not speak or breathe in the direction of the port catheter system during lancing.

  • Skin disinfection
    The puncture area is cleaned with a special solution (clear or coloured disinfectant).
  • Pierce
    The special needle is pushed through the skin and the silicone membrane into the port chamber. The patient feels the slight prick with the needle. If this is unpleasant or very painful, the puncture site can be lightly anaesthetised with a pain-relieving ointment or spray half an hour before the puncture.
  • Checking the functionality
    The doctor draws blood from the port catheter with a syringe to check the correct position, followed by flushing with physiological saline solution 0.9 %.
  • Fixation
    For the duration of the therapy, the needle is fixed in place, e.g. with a plaster. After that, the port catheter system can be used.

Important: A cannula is intended for single use and should not be left lying around for longer than 48 hours (risk of infection otherwise increased).

  • Aspiration: Withdrawal of blood from the catheter.
  • Implantation: Surgical insertion
  • Intravenous therapy: drug administration into the vein
  • NaCl 0.9: physiological saline solution, e.g. for rinsing the catheter
  • Parenteral nutrition: Administration of nutrients/electrolytes/vitamins/trace elements into the vein bypassing the digestive tract.
  • Peripheral veins: Veins in arms and legs
  • Bolus administration: single dose

This port catheter system in combination with suitable cannulae enables a high-pressure infusion of contrast media into the central circulatory system. The system is suitable to achieve a flow rate of 5ml/s at a maximum pressure of 21 bar (300 PSI). The pressure stability is tested accordingly and the indication of the suitable port systems or cannulas can be found with us, e.g. by a separate marking for the suitable articles.

A port catheter system, also called a port, port catheter or port system for short, is a long-term access option to the vascular system. It is implanted under the protection of the skin. The implantation is done through a relatively small operation, which can also be done on an outpatient basis under local anaesthesia. The port catheter system consists of the titanium port chamber and a catheter. The titanium port chamber is sealed with a silicone membrane. For the administration of medication, so-called artificial nutrition or blood sampling, a special port cannula is inserted through the skin and through the silicone membrane into the titanium port chamber.

The port catheter system provides permanent access to the vascular system, whereby the catheter is placed in a peripheral blood vessel, usually a vein. This allows access to the vascular system at any time and avoids straining the peripheral veins through multiple punctures. Protecting the skin reduces the risk of infection.

In most cases, it is used for tumour patients who need repeated chemotherapy. The quality of life is significantly improved because the patient’s freedom of movement is not restricted and piercing is much easier and less risky. Normal activities are possible, even sports, swimming, cycling, etc. The implanted port chamber is only slightly raised under the skin and is usually visually unnoticeable. However, it can be easily felt.

The tip of the port catheter is usually in a large vein in front of the heart entrance, the superior vena cava.
The catheter is usually inserted through the subclavian or internal jugular vein or the external jugular vein.
The port chamber is usually located above the right costal arch.
However, other localisations are also possible. This is decided by the doctor.

The implantation of the port catheter system takes place in the clinic as an inpatient or also as an outpatient within about one hour.
Up to two skin incisions are made and the port is pushed under the skin and the catheter is inserted into the large vein.
The patient can choose between a general or local anaesthetic.
The decision should be discussed with the doctor in charge.

During the first few days after the operation you may experience a slight pain or swelling of the skin area, this is normal.
If this persists, reddening of the skin, fever or bleeding occurs, the patient should consult a doctor to avoid complications.
The skin incisions are sutured or covered with sterile plaster strips. These can be removed painlessly from the 8th day after the operation.
When a bandage is no longer necessary, the patient can shower and later bathe after complete healing.
Within the first 14 days, the patient should still take it easy.
The port can be used immediately.

All the drugs that are approved for intravenous therapy can be given via the port catheter system.
This can be:
Infusion solutions such as NaCl, glucose, electrolytes, cytostatics, antibiotics, painkillers such as morphine, parenteral nutrition such as fats, amino acids (protein) and blood products such as platelet concentrates.

The corresponding instructions for use and care recommendations must be observed.
The patient should also carry a patient passport with him/her at all times, if possible, in which all important information is documented.
The doctor will decide when to give which medicine.
It is very important to rinse the port catheter system thoroughly after each administration of medication, otherwise it could become blocked.

Important: The port chamber is not a reservoir and is not filled with blood or medication! After rinsing, it may only contain the appropriate rinsing solution (e.g. saline/heparin solution).

To pierce the port catheter system, the doctor needs needles with a special cut.
Only these special cannulas prevent the silicone membrane from being perforated and punched out.
We recommend the SFN® port cannulas, which are available in different stitch lengths and diameters, depending on e.g. the administration of medication

Example of a procedure:
The patient can sit or lie down comfortably.
The piercing is done under germ-free conditions (sterile) so that the port system retains its function for a long time and does not become infected.
The patient should not speak or breathe in the direction of the port catheter system during lancing.

  • Skin disinfection
    The puncture area is cleaned with a special solution (clear or coloured disinfectant).
  • Pierce
    The special needle is pushed through the skin and the silicone membrane into the port chamber. The patient feels the slight prick with the needle. If this is unpleasant or very painful, the puncture site can be lightly anaesthetised with a pain-relieving ointment or spray half an hour before the puncture.
  • Checking the functionality
    The doctor draws blood from the port catheter with a syringe to check the correct position, followed by flushing with physiological saline solution 0.9 %.
  • Fixation
    For the duration of the therapy, the needle is fixed in place, e.g. with a plaster. After that, the port catheter system can be used.

Important: A cannula is intended for single use and should not be left lying around for longer than 48 hours (risk of infection otherwise increased).

The patient should generally observe him/herself daily and pay particular attention to the area around the port catheter system, as well as any swelling of the lymph nodes under the armpits; changes should be reported to the doctor and nurse.
When not in use, flush approx. every 3 months to prevent occlusion of the port catheter system. This is usually done by the family doctor as part of the regular blood checks.

If the port needle is in place, additional daily checks are carried out by the doctor and nursing staff, who check that the port needles are correctly positioned and fixed in place.

Regular flushing is also necessary when giving infusions.
This is particularly necessary before and after the administration of blood samples and after different infusions (interactions) given one after the other.
The doctor and/or nurse flushes the catheter with a syringe filled with at least 10 ml NaCL 0.9 % (10-30 ml saline solution).

Only syringes larger than 10 ml are recommended for each bolus administration.
The same procedure is required when pulling the needle.
This protects the catheter system in the long term.

Problem Possible cause What can be done about it?
Higher resistance when injecting, no aspiration of blood. The catheter tip may rest against the vessel wall.
  • Often a change of position of the upper body helps
  • Movement of the upper arm
  • Inhale while holding your breath for a short moment.
Port and catheter cannot be flushed under normal pressure. No blood can be drawn. Port catheter closure In all these cases, contact the family doctor immediately. The doctor will then discuss the necessary steps together with the patient.
Physical discomfort, pain and possibly swelling in the area of the shoulder, neck and arm Vein thrombosis
Pain and/or redness at the implantation site, fever or an unusual discharge at the injection site Infection of the port pocket
Burning pain after infusion of a drug, possibly in combination with blistering of the skin or swelling in the area of the port pocket Leaky system, the drug seeps into the surrounding tissue.
THESE COMPLICATIONS ARE EXTREMELY RARE, BUT CANNOT BE RULED OUT.
Problem Possible cause What can be done about it?
Rejection of the port by the body Incompatibility of the materials In all these cases, contact the family doctor immediately. The doctor will then discuss the necessary steps together with the patient.
Spontaneous slippage of the port Inappropriate fixation of the port during implantation
Twisting or slipping of the port as a result of unusual movements Inappropriate fixation of the port during implantation
Pinching of the catheter between the clavicle and the first rib Individual, anatomical position. td,
Surgical technique.
The duration of use of a port system is largely determined by careful, germ-free handling and regular port flushing.
The port system may well remain in the body for several years and it is surgically removed if this system is no longer needed.
It is recommended to carry a special puncture needle for emergencies so that the port catheter system can be punctured at any time.
It is best if a suitable puncture needle is always carried by the patient with the patient passport.
Immediately after the operation, physically strenuous activities must be avoided at all costs.
After the small incisions have healed, the normal way of life can be resumed.
If no needle is inserted, the port wearer can bathe, swim and do sports as he did before the implantation, with the consent of his doctor.
The port lies completely under the skin. A slight increase in the skin is visually less noticeable.
However, the exact location of the port can be easily felt.
The small scars resulting from the implantation will become less noticeable over time.
No. In principle, however, we recommend that when you visit another doctor, you inform him or her immediately about the port, preferably by presenting the implantation card. This also applies to all diagnostic examinations and emergency treatments.
The port can remain in place as long as it is necessary for the treatment of the disease.
Afterwards, it can be easily removed by a short surgical procedure under local anaesthesia.
In some patients it may be necessary to replace the port during long-term therapy, i.e. the old port is removed and replaced with a new one.
The port is made of pure TITAN.
The material properties of our ports have been extensively tested.
Since it is metal, the corresponding properties cannot be averted.
Test results show a harmlessness for possible MRI examinations, which behave within the parameters, see below (see also instructions for use):
MRI safety information

MR conditionally safe
Non-clinical tests have shown that the “Titan Port Chamber” MRbedingt
is safe. A patient with this product can be safely treated in a
MR system that meets the following conditions:
– Static magnetic field of 1.5 Tesla and 3 Tesla, with
– Maximum spatial field gradient of 12,900 G/cm (129 T/m)
– Maximum force product of 231,000,000 G2/cm (231 T2/m)
– Theoretically estimated maximum whole-body averaged (WBA)
specific absorption rate (SAR) of 2 W/kg (normal operating mode).
Under the scanning conditions defined above, it is expected that the
“Titanium port chamber” a maximum temperature rise of less than
2.3 °C (2 W/kg, 1.5 Tesla) RF-induced temperature increase with
Background temperature increase of 1.4 °C (2 W/kg, 1.5 Tesla)
3.9 °C (2 W/kg, 3 Tesla) RF-induced temperature increase with a
Background temperature increase of 2.0 °C (2 W/kg, 3 Tesla)
after 15 minutes of continuous scanning.
In non-clinical tests, the product induced
Image artefact when recording with a gradient echo pulse sequence and
a 3 Tesla MR system approx. 34.0 mm from the “titanium port chamber”.
It is extremely important that patients with an implanted port always carry a card with the appropriate medical information.
Especially in emergencies, this can be essential.
Therefore, patients should ask the operating doctor or one of the nurses to hand out the patient passport.
This ID card should always be carried by the patient and presented when visiting the doctor or in case of hospitalisation
  • Aspiration: Withdrawal of blood from the catheter.
  • Implantation: Surgical insertion
  • Intravenous therapy: drug administration into the vein
  • NaCl 0.9: physiological saline solution, e.g. for rinsing the catheter
  • Parenteral nutrition: Administration of nutrients/electrolytes/vitamins/trace elements into the vein bypassing the digestive tract.
  • Peripheral veins: Veins in arms and legs
  • Bolus administration: single dose

This port catheter system in combination with suitable cannulae enables a high-pressure infusion of contrast media into the central circulatory system. The system is suitable to achieve a flow rate of 5ml/s at a maximum pressure of 21 bar (300 PSI). The pressure stability is tested accordingly and the indication of the suitable port systems or cannulas can be found with us, e.g. by a separate marking for the suitable articles.

Der TITAN-PORT APH (extrakorporale Apherese) ist ein vollständig implantierbares Portkathetersystem als Zugangsmöglichkeit zur Durchführung einer extrakorporalen Apherese

So kann jederzeit der Zugang zum Gefäßsystem erfolgen und es wird vermieden, dass durch vielfaches Einstechen die peripheren Venen strapaziert werden. Durch den Schutz der Haut wird ein Infektionsrisiko verringert.

Die Lebensqualität wird deutlich verbessert, weil der Patient in seiner Bewegungsfreiheit nicht eingeschränkt ist und das Anstechen deutlich einfacher und risikoärmer ist. Normale Tätigkeiten sind möglich, sogar Sport, Schwimmen, Radfahren, etc. Die implantierte Portkammer liegt nur leicht erhaben unter der Haut und fällt optisch meist wenig auf. Sie kann aber leicht ertastet werden.

Die Portkatheter liegt meistens in einer großen Vene vor dem Herzeingang, der Vena cava superior.
Der Katheter wird meistens über die  Vena jugularis interna oder externa eingeführt.

Die Portkatheterspitze liegt 2-4 cm im rechten Vorhof.Die Portkammer liegt meist über dem rechten Rippenbogen.


Es sind aber auch andere Lokalisationen möglich. Dies entscheidet der Arzt.

Das Portkathetersystem ermöglicht durch sein stromlinienförmiges Design mit Verwendung gerade Portkanülen einen optimalen Flow.

Auf Grund des optimierten Designs können bei der Apherese Flows bis zu 250 ml/min erreicht werden.

Die Implantation des Portkathetersystems erfolgt stationär in der Klinik oder auch ambulant innerhalb von etwa einer Stunde.
Dabei werden bis zu zwei Hautschnitte durchgeführt und der Port unter die Haut geschoben sowie der Katheter in die große Vene eingeführt.
Der Patient kann zwischen einer Vollnarkose oder einer Lokalanästhesie wählen.
Die Entscheidung sollte mit dem zuständigen Arzt besprochen werden.

An den ersten Tagen nach der Operation kann ein leichter Schmerz oder eine Schwellung des Hautbereiches auftreten, dies ist normal.
Sollte dies länger anhalten, eine Rötung der Haut, Fieber oder Blutungen auftreten, sollte der Patient zur Vermeidung von Komplikationen einen Arzt aufsuchen.
Die Hautschnitte sind genäht oder mit sterilen Pflasterstreifen überklebt. Diese können ab dem 8. Tag nach der Operation schmerzlos entfernt werden.
Wenn kein Verband mehr notwendig ist, kann der Patient duschen und später nach vollständiger Abheilung auch baden.
Innerhalb der ersten14 Tage sollte der Patient sich noch körperlich schonen.
Der Port kann nach ca 7 Tagen nach Abschluss der Wundheilung zur Therapie genutzt werden.

Zum Anstechen des Portkathetersystems benötigt der Arzt Nadeln mit einem besonderen Schliff.
Nur diese Spezialkanülen verhindern ein Durchlöchern und Ausstanzen der Silikonmembran.
Die stanzfreien SFN®-Portkanülen sind obligatorisch. Für die Apheresetherapie werden die 18 Gauge, 17 Gauge und 15 Gauge SFN-Portkanülen empfohlen.
  • Vor der Implantation ideale Implantationsstelle mit dem Patient besprechen und markieren
  • In Lokalanästhesie kann das Portkathetersystem mittels Seldingertechnik über die jugularis interna, externa bzw. subclavia bis in den rechten Vorhof implantiert werden (Länge des Katheters entsprechend kürzen und im Implantats-Ausweis dokumentieren)
  • Zum Auffüllen des Katheters das Venenhäkchen festhalten, Alternativ den Dilatator verwenden
  • Theoretisch ist das System sofort benutzbar, empfohlen wird die Nutzung nach Abschluss der Wundheilung nach ca. einer Woche – ggf. System nach Implantation blocken
    • Benutzung nur mit sterilen Handschuhen, Mundschutz (Patient und Anwender), steriler Abdeckung
    • Nach jeder Behandlung mit 30 ml NaCl 0,9 % pulsierend spülen, Nadel unter positivem Druck ziehen
    • Anschließend Blockmittel verwenden: die Volumina für Katheter, Portkammer und Kanüle entnehmen die bitte der jeweils aktuellen Gebrauchsanweisung

     

    Empfehlung: als Blockmittel z. B. Citrat, Taurolidin-Citrat, Heparin, Urokinase/Streptokinase

    (verdünntes Heparin ist aufgrund der kurzen Halbwertszeit nicht empfehlenswert)

     

    Dies sind Empfehlungen, sie müssen immer der allgemeinen Gerinnungssituation des Patienten angepasst werden und liegen im Verantwortungsbereich des behandelnden Arztes.

    • Vor der Benutzung des Ports Blockmittel aspirieren
    • Bei persistierenden Problemen des Durchflusses evtl. Lyse

    (vorher evtl. Röntgenkontrolle durchführen)

    Obligatorisch nur stanzfreie Portkanülen verwenden

 

  • bei längerer Therapiepause bzw. Therapieabschluss empfielt sich eine Spülung mit NaCl 0,9 % ca. alle 3-4 Wochen und anschließend wie oben angegeben blocken
  • bei Neigung zu Thrombosebildung ist eine angemessene Thromboseprophylaxe zu empfehlen
  • Kanüle sitzt nicht richtig in der Portkammer à Kanüle bis zur Bodenplatte einschieben

 

  • a. Thrombusbildung? à Lyse notwendig
  • Katheter wurde bei Implantation verdreht oder geknickt à Korrektur notwendig
  • Katheter liegt nicht richtig im Vorhof à Korrektur notwendig

Beispiel eines Vorgehens:
Der Patient kann dabei bequem sitzen oder liegen.
Das Anstechen erfolgt unter keimfreien Bedingungen (steril), damit das Portsystem lange seine Funktion behält und nicht infiziert wird.
Der Patient sollte während des Anstechens nicht in die Richtung des Portkathetersystems sprechen und atmen.

  • Hautdesinfektion
    Dabei wird das Punktionsgebiet mit einer speziellen Lösung (Desinfektionsmittel klar oder gefärbt) gereinigt.
  • Anstechen
    Die Spezialnadel wird durch die Haut und die Silikonmembran in die Portkammer geschoben. Der Patient spürt dabei den leichten Einstich mit der Nadel. Sollte dies unangenehm sein oder sehr schmerzhaft sein, kann die Einstichstelle eine halbe Stunde vor dem Einstich mit einer schmerzlindernden Salbe oder Spray leicht betäubt werden.
  • Überprüfung der Funktionsfähigkeit
    Mit einer Spritze zieht der Arzt Blut aus dem Portkatheter und überprüft damit die korrekte Lage, anschließend erfolgt eine Spülung mit physiologischer Kochsalzlösung 0,9 %.
  • Fixation
    Für die Dauer der Therapie wird die Nadel z. B. mit einem Pflaster fixiert. Danach kann das Portkathetersystem benutzt werden.

Wichtig: Eine Kanüle ist jeweils für den Einmalgebrauch bestimmt und sollte nicht länger als 48 Stunden liegen bleiben (Infektionsgefahr sonst erhöht)

Der Patient sollte sich generell täglich beobachten und besonders auf die Umgebung des Portkathetersystems, sowie auf ein Anschwellen der Lymphknoten unter den Achseln achten, Veränderungen sollten dem Arzt und der Pflegekraft mitgeteilt werden.
Bei Nichtbenutzung, Spülung ca. alle 3 Monate, um einen Verschluss des Portkathetersystems zu verhindern. Dies geschieht in der Regel beim Hausarzt im Rahmen der regelmäßigen Blutkontrollen.

Bei liegender Portnadel erfolgen zusätzlich tägliche Kontrollen durch den Arzt und Pflegepersonal, sie begutachten den richtigen Sitz der Port Nadeln und die korrekte Fixierung.

Auch bei der Gabe von Infusionen, sind regelmäßige Spülungen notwendig.
Dies ist insbesondere notwendig vor und nach der Gabe von Blutproben und nach unterschiedlichen Infusionen (Interaktionen), die nacheinander gegeben werden.
Der Arzt und/oder die Pflegekraft spült dabei mit einer mindestens 10 ml Spritze gefüllt mit 10 ml NaCL 0,9 % (10-30 ml Kochsalzlösung) den Katheter.

Für jede Bolusgabe werden nur Spritzen über 10 ml Größe empfohlen.
Gleiche Vorgehensweise ist auch beim Ziehen der Nadel erforderlich.
Dadurch wird das Kathetersystem langfristig geschützt.

ProblemMögliche UrsacheWas kann dagegen getan werden?
Höherer Widerstand beim Spritzen, keine Aspiration von Blut.Die Katheterspitze liegt möglicherweise an der Gefäßwand an.
  • Oft hilft eine Lageveränderung des Oberkörpers
  • Bewegung des Oberarms
  • Einatmen und dabei die Luft einen kurzen Moment anhalten.
Port und Katheter lassen sich bei normalem Druck nicht spülen. Es kann kein Blut entnommen werden.PortkatheterverschlussIn all diesen Fällen muss sofort Kontakt zum Hausarzt aufgenommen werden. Der Arzt wird dann die notwendigen Schritte gemeinsam mit dem Patienten besprechen.
Körperliches Unbehagen, Schmerzen und evtl. Schwellungen im Bereich von Schulter, Hals und ArmVenenthrombose
Schmerzen und/oder Rötungen an der Implantationsstelle, Fieber oder ein ungewöhnlicher Ausfluss an der EinstichstelleInfektion der Porttasche
Brennender Schmerz nach Infusion eines Medikaments, evtl. in Kombination mit Blasenbildung auf der Haut oder Schwellung im Bereich der PorttascheUndichtes System, das Medikament sickert in das umliegende Gewebe.
DIESE KOMPLIKATIONEN SIND ÄUSSERST SELTEN, ABER NICHT AUSZUSCHLIESSE
ProblemMögliche UrsacheWas kann dagegen getan werden?
Abstoßung des Ports durch den KörperUnverträglichkeit der MaterialienIn all diesen Fällen muss sofort Kontakt zum Hausarzt aufgenommen werden. Der Arzt wird dann die notwendigen Schritte gemeinsam mit dem Patienten besprechen.
Spontanes Verrutschen des PortsNicht sachgerechtes Fixieren des Ports bei der Implantation
Verdrehen oder Verrutschen des Ports als Folge ungewöhnlicher BewegungenNicht sachgerechtes Fixieren des Ports bei der Implantation
Einklemmung des Katheters zwischen Schlüsselbein und erster RippeIndividuelle, anatomische Lage. 
Operationstechnik.
Die Liegedauer eines Portsystems wird zum größten Teil durch den vorsichtigen, keimfreien Umgang und die regelmäßigen Portspülungen bestimmt.
Das Portsystem kann durchaus mehrere Jahre im Körper verbleiben und es wird, falls dieses System nicht mehr benötigt wird, operativ entfernt.
Es wird empfohlen für Notfälle eine spezielle Punktionsnadel bei sich zu führen, damit jederzeit das Portkathetersystem angestochen werden kann.
Am besten sollte eine geeignete Punktionsnadel mit dem Patientenpass immer vom Patienten mitgeführt werden.
Unmittelbar nach der Operation müssen körperlich anstrengende Aktivitäten unbedingt vermieden werden.
Nach dem Abheilen der kleinen Einschnitte kann die normale Lebensweise wieder aufgenommen werden.
Wenn keine Nadel gelegt ist, kann der Portträger mit Zustimmung seines Arztes baden, schwimmen und Sport treiben so wie er es vor der Implantation getan hat.
Der Port liegt vollständig unter der Haut. Eine geringe Erhöhung der Haut fällt optisch wenig auf.
Die genaue Lage des Ports kann jedoch leicht ertastet werden.
Die kleinen Narben, die von der Implantation herrühren, werden im Laufe der Zeit immer weniger auffallen.
Nein. Grundsätzlich empfehlen wir aber, beim Besuch eines anderen Arztes, diesen sofort über den Port zu informieren, am besten durch Vorlage des Implantationsausweises. Das gilt auch für alle diagnostischen Untersuchungen und Notfallbehandlungen.
Der Port kann so lange eingesetzt bleiben, wie es für die Behandlung der Krankheit notwendig ist.
Danach kann er durch einen kurzen operativen Eingriff in Lokalanästhesie problemlos wieder entfernt werden.
Bei manchen Patienten kann es notwendig werden, den Port während der Langzeittherapie auszutauschen, d.h. der alte Port wird entfernt und durch einen neuen ersetzt.
Der Port ist aus reinem TITAN.
Die Materialeigenschaften unserer Ports wurden umfassend getestet.
Da es sich um Metall handelt sind entsprechend Eigenschaften nicht abzuwenden. 
 
Testergebnisse zeigen eine Unbedenklichkeit für mögliche MRT-Untersuchungen, die sich im Rahmen der Parameter, s.u. verhalten (s. auch Gebrauchsanweisung):
 
 
MRT-Sicherheitsinformationen

                                                      MR-bedingt sicher

Nichtklinische Tests haben gezeigt, dass die “Titan Portkammer” MRbedingt
sicher ist. Ein Patient mit diesem Produkt kann sicher in einem
MR-System gescannt werden, das die folgenden Bedingungen erfüllt:
– Statisches Magnetfeld von 1,5 Tesla und 3 Tesla, mit
– Maximalem räumlichen Feldgradient von 12.900 G/cm (129 T/m)
– Maximales Kraftprodukt von 231.000.000 G2/cm (231 T2/m)
– Theoretisch geschätzte maximale ganzkörpergemittelte (WBA)
spezifische Absorptionsrate (SAR) von 2 W/kg (normaler Betriebsmodus).
Unter den oben definierten Scanbedingungen wird erwartet, dass die
“Titan Portkammer” einen maximalen Temperaturanstieg von weniger als
2,3 °C (2 W/kg, 1,5 Tesla) HF-bedingte Temperaturerhöhung bei einer
Hintergrundtemperaturerhöhung von 1,4 °C (2 W/kg, 1,5 Tesla)
3,9 °C (2 W/kg, 3 Tesla) HF-bedingte Temperaturerhöhung bei einer
Hintergrundtemperaturerhöhung von 2,0 °C (2 W/kg, 3 Tesla)
nach 15 Minuten kontinuierlichem Scannen.
In nicht-klinischen Tests erstreckt sich das durch das Produkt verursachte
Bildartefakt bei der Aufnahme mit einer Gradientenecho-Pulsfolge und
einem 3-Tesla-MR-System ca. 34,0 mm von der “Titan-Portkammer”.
Es ist äußerst wichtig, dass Patienten mit einem implantierten Port stets eine Karte mit der entsprechenden medizinischen Information bei sich tragen.
Vor allem in Notfällen kann das von wesentlicher Bedeutung sein.
Daher sollten Patienten den operierenden Arzt oder eine der Schwestern um die Aushändigung des Patientenpasses bitten.
Dieser Ausweis sollte immer vom Patienten mit sich geführt werden und beim Arztbesuch oder im Falle einer Krankenhauseinweisung vorgelegt werden
  • Aspiration: Zurückziehen von Blut aus dem Katheter.
  • Implantation: Operatives Einsetzen
  • Intravenöse Therapie: Medikamentengabe in die Vene
  • NaCl 0,9: Physiologische Kochsalzlösung z. B zum Spülen des Katheters
  • Parenterale Ernährung: Gabe von Nährstoffen/Elektrolyten/Vitaminen/ Spurenelementen in die Vene unter Umgehung des Verdauungstraktes.
  • Periphere Venen: Venen in Armen und Beinen
  • Bolusgabe: Einmalgabe

Dieses Portkathetersystem in Kombination mit geeigneten Kanülen ermöglicht eine Hochdruckinfusion von Kontrastmitteln in das zentrale Kreislaufsystem. Das System ist geeignet, eine Durchflussrate von 5ml/s bei einem Maximaldruck von 21 bar (300 PSI) zu erreichen. Die Druckstabilität wird entsprechend geprüft und den Hinweis auf die geeigneten Portsysteme oder Kanülen finden Sie bei uns z.B. durch eine gesonderte Kennzeichnung für die passenden Artikel.

Yes ANOKRYO® can be used during these periods without any problems. As opposed to other gel and ointment preparations, there are no side effects.

Depending on symptoms approx. 3-4 x daily.

ANOKRYO® combines two therapeutic principles: dilatation and low temperature application.

This is not a problem. The important thing is that the ANOKRYO® rod be stored in the freezer. Normal refrigerator temperatures are insufficient.

No! Due to its water solubility it would freeze. The gel is applied prior to use.

No there are no adverse effects (see IFU).

Yes without any problems. Anokryo is also helpful in treating constipation

ANOKRYO® is available in the pharmacy or may be ordered there on a non-prescription basis. You may order it at this internet site.

You can reorder the gel from the pharmacy (PZN 07470157) or directly from us here on this website. (Note: No ointment or Vaseline! (Impedes the cold effect)
The product may be used for approx. 3 years.
In this case any other plastic container can be used to store the product.
No. ANOKRYO® is sold over the counter in pharmacies and does not require a prescription.
It is an effective medical aid having no adverse effects.
There are no restrictions concerning frequency of applications.
No, cleaning with basic domestic soap suffices.

You can purchase the product at this internet website. Modes of payment are explained at the site.

ANOKRYO® -combi-set: PZN 03941536.
ANOKRYO® -gel: PZN 07470157.

Yes the instructions for usage have been translated in various languages.

No. There is only one production size.

The rod is made of tissue compatible plastic.

Relief is felt almost immediately when the cooling effect sets in.
No the rod is stored in the container and is placed in the freezer.
Optimal temperature is reached after 2 hours.
No. Initially there may be some minor discomfort due to the cold temperature. Some mild pain may be felt in cases of anal fissure when the sphincter muscle is dilated.
A single treatment lasts 5- 10 minutes.
No. Vaseline in particular should not be used nor should any other ointments be applied.
You can prevent it by eating a diet rich in fibre, drinking enough, getting plenty of exercise and having regular bowel movements.
To pierce the port catheter system, the doctor needs needles with a special cut.
Only these special cannulas prevent the silicone membrane from being perforated and punched out.
We recommend the SFN® port cannulas, which are available in different stitch lengths and diameters, depending on, for example, the administration of medication, the patient’s anatomy and the place and type of application.

Puncture of the port system requires the use of a special needle with a bevelled tip. These needles are the only way to avoid punching defects on the silicone membrane. The needles are available in different lengths and bore diameters depending on which substances are to be injected.

The port needle is used to puncture the port chamber. The needle tip pierces a silicone membrane of the port.

Only port needles have a special needle tip. Only with these needles can punching defects on the silicone membrane be avoided.

It is doubly safe as it has a special safety system designed to prevent needlestick injuries.

The operator will find all details about the safety system in the respective instruction manual.

Yes, but we recommend our 100% guaranteed punch-free needles.

SFN stands for “punch-free needle”.

A “Huber” cannula (named after the inventor) is a commonly used port needle for accessing the port.

The tip is different from PakuMed’s SFN port needle.

The choice of size depends, among other things, on the patient’s anatomy, the location and type of application and is the decision of the doctor.

The port cannula is for single use and can remain in the port for up to 48 hours (recommended). Thus, this can be used to administer medicines and fluids, such as artificial food, over a longer period of time.

Example of a procedure:
The patient can sit or lie down comfortably.
The piercing is done under germ-free conditions (sterile) so that the port system retains its function for a long time and does not become infected.
The patient should not speak or breathe in the direction of the port catheter system during lancing.

  • Skin disinfection
    The puncture area is cleaned with a special solution (clear or coloured disinfectant).
  • Pierce
    The special needle is pushed through the skin and the silicone membrane into the port chamber. The patient feels the slight prick with the needle. If this is unpleasant or very painful, the puncture site can be lightly anaesthetised with a pain-relieving ointment or spray half an hour before the puncture.
  • Checking the functionality
    The doctor draws blood from the port catheter with a syringe to check the correct position, followed by flushing with physiological saline solution 0.9 %.
  • Fixation
    For the duration of the therapy, the needle is fixed in place, e.g. with a plaster. After that, the port catheter system can be used.

Important: A cannula is intended for single use and should not be left lying around for longer than 48 hours (risk of infection otherwise increased).

  • Aspiration: Withdrawal of blood from the catheter.
  • Implantation: Surgical insertion
  • Intravenous therapy: drug administration into the vein
  • NaCl 0.9: physiological saline solution, e.g. for rinsing the catheter
  • Parenteral nutrition: Administration of nutrients/electrolytes/vitamins/trace elements into the vein bypassing the digestive tract.
  • Peripheral veins: Veins in arms and legs
  • Bolus administration: single dose

This port catheter system in combination with suitable cannulae enables a high-pressure infusion of contrast media into the central circulatory system. The system is suitable to achieve a flow rate of 5ml/s at a maximum pressure of 21 bar (300 PSI). The pressure stability is tested accordingly and the indication of the suitable port systems or cannulas can be found with us, e.g. by a separate marking for the suitable articles.

A port catheter system, also called a port, port catheter or port system for short, is a long-term access option to the vascular system. It is implanted under the protection of the skin. The implantation is done through a relatively small operation, which can also be done on an outpatient basis under local anaesthesia. The port catheter system consists of the titanium port chamber and a catheter. The titanium port chamber is sealed with a silicone membrane. For the administration of medication, so-called artificial nutrition or blood sampling, a special port cannula is inserted through the skin and through the silicone membrane into the titanium port chamber.

The port catheter system provides permanent access to the vascular system, whereby the catheter is placed in a peripheral blood vessel, usually a vein. This allows access to the vascular system at any time and avoids straining the peripheral veins through multiple punctures. Protecting the skin reduces the risk of infection.

In most cases, it is used for tumour patients who need repeated chemotherapy. The quality of life is significantly improved because the patient’s freedom of movement is not restricted and piercing is much easier and less risky. Normal activities are possible, even sports, swimming, cycling, etc. The implanted port chamber is only slightly raised under the skin and is usually visually unnoticeable. However, it can be easily felt.

The tip of the port catheter is usually in a large vein in front of the heart entrance, the superior vena cava.
The catheter is usually inserted through the subclavian or internal jugular vein or the external jugular vein.
The port chamber is usually located above the right costal arch.
However, other localisations are also possible. This is decided by the doctor.

The implantation of the port catheter system takes place in the clinic as an inpatient or also as an outpatient within about one hour.
Up to two skin incisions are made and the port is pushed under the skin and the catheter is inserted into the large vein.
The patient can choose between a general or local anaesthetic.
The decision should be discussed with the doctor in charge.

During the first few days after the operation you may experience a slight pain or swelling of the skin area, this is normal.
If this persists, reddening of the skin, fever or bleeding occurs, the patient should consult a doctor to avoid complications.
The skin incisions are sutured or covered with sterile plaster strips. These can be removed painlessly from the 8th day after the operation.
When a bandage is no longer necessary, the patient can shower and later bathe after complete healing.
Within the first 14 days, the patient should still take it easy.
The port can be used immediately.

All the drugs that are approved for intravenous therapy can be given via the port catheter system.
This can be:
Infusion solutions such as NaCl, glucose, electrolytes, cytostatics, antibiotics, painkillers such as morphine, parenteral nutrition such as fats, amino acids (protein) and blood products such as platelet concentrates.

The corresponding instructions for use and care recommendations must be observed.
The patient should also carry a patient passport with him/her at all times, if possible, in which all important information is documented.
The doctor will decide when to give which medicine.
It is very important to rinse the port catheter system thoroughly after each administration of medication, otherwise it could become blocked.

Important: The port chamber is not a reservoir and is not filled with blood or medication! After rinsing, it may only contain the appropriate rinsing solution (e.g. saline/heparin solution).

To pierce the port catheter system, the doctor needs needles with a special cut.
Only these special cannulas prevent the silicone membrane from being perforated and punched out.
We recommend the SFN® port cannulas, which are available in different stitch lengths and diameters, depending on e.g. the administration of medication

Example of a procedure:
The patient can sit or lie down comfortably.
The piercing is done under germ-free conditions (sterile) so that the port system retains its function for a long time and does not become infected.
The patient should not speak or breathe in the direction of the port catheter system during lancing.

  • Skin disinfection
    The puncture area is cleaned with a special solution (clear or coloured disinfectant).
  • Pierce
    The special needle is pushed through the skin and the silicone membrane into the port chamber. The patient feels the slight prick with the needle. If this is unpleasant or very painful, the puncture site can be lightly anaesthetised with a pain-relieving ointment or spray half an hour before the puncture.
  • Checking the functionality
    The doctor draws blood from the port catheter with a syringe to check the correct position, followed by flushing with physiological saline solution 0.9 %.
  • Fixation
    For the duration of the therapy, the needle is fixed in place, e.g. with a plaster. After that, the port catheter system can be used.

Important: A cannula is intended for single use and should not be left lying around for longer than 48 hours (risk of infection otherwise increased).

The patient should generally observe him/herself daily and pay particular attention to the area around the port catheter system, as well as any swelling of the lymph nodes under the armpits; changes should be reported to the doctor and nurse.
When not in use, flush approx. every 3 months to prevent occlusion of the port catheter system. This is usually done by the family doctor as part of the regular blood checks.

If the port needle is in place, additional daily checks are carried out by the doctor and nursing staff, who check that the port needles are correctly positioned and fixed in place.

Regular flushing is also necessary when giving infusions.
This is particularly necessary before and after the administration of blood samples and after different infusions (interactions) given one after the other.
The doctor and/or nurse flushes the catheter with a syringe filled with at least 10 ml NaCL 0.9 % (10-30 ml saline solution).

Only syringes larger than 10 ml are recommended for each bolus administration.
The same procedure is required when pulling the needle.
This protects the catheter system in the long term.

Problem Possible cause What can be done about it?
Higher resistance when injecting, no aspiration of blood. The catheter tip may rest against the vessel wall.
  • Often a change of position of the upper body helps
  • Movement of the upper arm
  • Inhale while holding your breath for a short moment.
Port and catheter cannot be flushed under normal pressure. No blood can be drawn. Port catheter closure In all these cases, contact the family doctor immediately. The doctor will then discuss the necessary steps together with the patient.
Physical discomfort, pain and possibly swelling in the area of the shoulder, neck and arm Vein thrombosis
Pain and/or redness at the implantation site, fever or an unusual discharge at the injection site Infection of the port pocket
Burning pain after infusion of a drug, possibly in combination with blistering of the skin or swelling in the area of the port pocket Leaky system, the drug seeps into the surrounding tissue.
THESE COMPLICATIONS ARE EXTREMELY RARE, BUT CANNOT BE RULED OUT.
Problem Possible cause What can be done about it?
Rejection of the port by the body Incompatibility of the materials In all these cases, contact the family doctor immediately. The doctor will then discuss the necessary steps together with the patient.
Spontaneous slippage of the port Inappropriate fixation of the port during implantation
Twisting or slipping of the port as a result of unusual movements Inappropriate fixation of the port during implantation
Pinching of the catheter between the clavicle and the first rib Individual, anatomical position. td,
Surgical technique.
The duration of use of a port system is largely determined by careful, germ-free handling and regular port flushing.
The port system may well remain in the body for several years and it is surgically removed if this system is no longer needed.
It is recommended to carry a special puncture needle for emergencies so that the port catheter system can be punctured at any time.
It is best if a suitable puncture needle is always carried by the patient with the patient passport.
Immediately after the operation, physically strenuous activities must be avoided at all costs.
After the small incisions have healed, the normal way of life can be resumed.
If no needle is inserted, the port wearer can bathe, swim and do sports as he did before the implantation, with the consent of his doctor.
The port lies completely under the skin. A slight increase in the skin is visually less noticeable.
However, the exact location of the port can be easily felt.
The small scars resulting from the implantation will become less noticeable over time.
No. In principle, however, we recommend that when you visit another doctor, you inform him or her immediately about the port, preferably by presenting the implantation card. This also applies to all diagnostic examinations and emergency treatments.
The port can remain in place as long as it is necessary for the treatment of the disease.
Afterwards, it can be easily removed by a short surgical procedure under local anaesthesia.
In some patients it may be necessary to replace the port during long-term therapy, i.e. the old port is removed and replaced with a new one.
The port is made of pure TITAN.
The material properties of our ports have been extensively tested.
Since it is metal, the corresponding properties cannot be averted.
Test results show a harmlessness for possible MRI examinations, which behave within the parameters, see below (see also instructions for use):
MRI safety information

MR conditionally safe
Non-clinical tests have shown that the “Titan Port Chamber” MRbedingt
is safe. A patient with this product can be safely treated in a
MR system that meets the following conditions:
– Static magnetic field of 1.5 Tesla and 3 Tesla, with
– Maximum spatial field gradient of 12,900 G/cm (129 T/m)
– Maximum force product of 231,000,000 G2/cm (231 T2/m)
– Theoretically estimated maximum whole-body averaged (WBA)
specific absorption rate (SAR) of 2 W/kg (normal operating mode).
Under the scanning conditions defined above, it is expected that the
“Titanium port chamber” a maximum temperature rise of less than
2.3 °C (2 W/kg, 1.5 Tesla) RF-induced temperature increase with
Background temperature increase of 1.4 °C (2 W/kg, 1.5 Tesla)
3.9 °C (2 W/kg, 3 Tesla) RF-induced temperature increase with a
Background temperature increase of 2.0 °C (2 W/kg, 3 Tesla)
after 15 minutes of continuous scanning.
In non-clinical tests, the product induced
Image artefact when recording with a gradient echo pulse sequence and
a 3 Tesla MR system approx. 34.0 mm from the “titanium port chamber”.
It is extremely important that patients with an implanted port always carry a card with the appropriate medical information.
Especially in emergencies, this can be essential.
Therefore, patients should ask the operating doctor or one of the nurses to hand out the patient passport.
This ID card should always be carried by the patient and presented when visiting the doctor or in case of hospitalisation
  • Aspiration: Withdrawal of blood from the catheter.
  • Implantation: Surgical insertion
  • Intravenous therapy: drug administration into the vein
  • NaCl 0.9: physiological saline solution, e.g. for rinsing the catheter
  • Parenteral nutrition: Administration of nutrients/electrolytes/vitamins/trace elements into the vein bypassing the digestive tract.
  • Peripheral veins: Veins in arms and legs
  • Bolus administration: single dose

This port catheter system in combination with suitable cannulae enables a high-pressure infusion of contrast media into the central circulatory system. The system is suitable to achieve a flow rate of 5ml/s at a maximum pressure of 21 bar (300 PSI). The pressure stability is tested accordingly and the indication of the suitable port systems or cannulas can be found with us, e.g. by a separate marking for the suitable articles.

The TITAN-PORT APH (extracorporeal apheresis) is a fully implantable port catheter system as an access option for performing extracorporeal apheresis

This allows access to the vascular system at any time and avoids straining the peripheral veins through multiple punctures. Protecting the skin reduces the risk of infection.

The quality of life is significantly improved because the patient’s freedom of movement is not restricted and piercing is much easier and less risky. Normal activities are possible, even sports, swimming, cycling, etc. The implanted port chamber is only slightly raised under the skin and is usually visually unnoticeable. However, it can be easily felt.

The port catheter is usually located in a large vein in front of the entrance to the heart, the superior vena cava.
The catheter is usually inserted via the internal or external jugular vein.

The port catheter tip is located 2-4 cm in the right atrium and the port chamber is usually above the right costal arch.

However, other localisations are also possible. This is decided by the doctor.

The port catheter system enables optimum flow thanks to its streamlined design with the use of straight port cannulas.

Due to the optimized design, flows of up to 250 ml/min can be achieved during apheresis.

The port catheter system is implanted in hospital or on an outpatient basis within around one hour.
Up to two skin incisions are made, the port is inserted under the skin and the catheter is inserted into the large vein.
The patient can choose between general or local anesthesia.
The decision should be discussed with the responsible doctor.

A slight pain or swelling of the skin area may occur in the first few days after the operation; this is normal.
If this persists for a longer period of time, reddening of the skin, fever or bleeding occurs, the patient should consult a doctor to avoid complications.
The skin incisions are sutured or covered with sterile plaster strips. These can be removed painlessly from the 8th day after the operation.
If a dressing is no longer necessary, the patient can shower and later, after complete healing, bathe.
The patient should take it easy physically for the first 14 days.
The port can be used for therapy after approx. 7 days once the wound has healed.

To pierce the port catheter system, the doctor needs needles with a special cut.
Only these special needles prevent perforation and punching out of the silicone membrane.
The punch-free SFN® port cannulas are mandatory. The 18 gauge, 17 gauge and 15 gauge SFN port cannulas are recommended for apheresis therapy
  • Discuss and mark the ideal implantation site with the patient before implantation
  • Under local anesthesia, the port catheter system can be implanted via the internal jugular, external jugular or subclavian vein into the right atrium using the Seldinger technique (shorten the length of the catheter accordingly and document it in the implant card)
  • Hold the venous hook to fill the catheter, alternatively use the dilator
  • Theoretically, the system can be used immediately; it is recommended to use it after the wound has healed after approx. one week – if necessary, block the system after implantation
    • Use only with sterile gloves, face mask (patient and user), sterile drape
    • After each treatment, rinse with 30 ml NaCl 0.9 % pulsating, pull needle under positive pressure
    • Then use the blocking agent: please refer to the current instructions for use for the volumes for the catheter, port chamber and cannula

    Recommendation: as a blocking agent e.g. citrate, taurolidine citrate, heparin, urokinase/streptokinase

    (diluted heparin is not recommended due to its short half-life)

    These are recommendations; they must always be adapted to the patient’s general coagulation situation and are the responsibility of the attending physician.

    • Aspirate blocking agent before using the port
    • If flow problems persist, possibly lysis

    (carry out an X-ray check beforehand if necessary)

    It is mandatory to use only punch-free port cannulas

  • In the event of a longer break in therapy or completion of therapy, we recommend rinsing with NaCl 0.9 % approx. every 3-4 weeks and then blocking as described above
  • Appropriate thrombosis prophylaxis is recommended if there is a tendency to develop thrombosis
  • Cannula is not seated correctly in the port chamber à Insert cannula up to the base plate
  • a. Thrombus formation? à Lysis necessary
  • Catheter was twisted or kinked during implantation à Correction necessary
  • Catheter is not positioned correctly in the atrium à Correction necessary

Example of a procedure:
The patient can sit or lie down comfortably.
The port is inserted under aseptic conditions (sterile) so that the port system retains its function for a long time and does not become infected.
The patient should not speak or breathe in the direction of the port catheter system during insertion.

  • Skin disinfection
    The puncture area is cleaned with a special solution (clear or colored disinfectant).
  • Piercing
    The special needle is pushed through the skin and the silicone membrane into the port chamber. The patient feels the slight prick with the needle. If this is unpleasant or very painful, the puncture site can be lightly anaesthetised with a pain-relieving ointment or spray half an hour before the puncture.
  • Checking the functionality
    The doctor draws blood from the port catheter with a syringe to check the correct position, followed by flushing with physiological saline solution 0.9%.
  • Fixation
    The needle is fixed in place, e.g. with a plaster, for the duration of the therapy. After that, the port catheter system can be used.

Important: A cannula is intended for single use and should not be left lying around for longer than 48 hours (risk of infection otherwise increased).

The patient should generally observe themselves daily and pay particular attention to the area around the port catheter system and any swelling of the lymph nodes under the armpits; any changes should be reported to the doctor and nurse.
If not in use, flush approx. every 3 months to prevent the port catheter system from becoming blocked. This is usually done by the family doctor as part of the regular blood checks.

If the port needle is in place, additional daily checks are carried out by the doctor and nursing staff, who check that the port needles are correctly positioned and fixed in place.

Regular rinsing is also necessary when administering infusions.
This is particularly necessary before and after the administration of blood samples and after different infusions (interactions), which are given one after the other.
The doctor and/or nurse flushes the catheter with a syringe filled with at least 10 ml NaCL 0.9 % (10-30 ml saline solution).

Only syringes larger than 10 ml are recommended for each bolus administration.
The same procedure is also required when withdrawing the needle.
This protects the catheter system in the long term.

Problem Possible cause What can be done about it?
Higher resistance when injecting, no aspiration of blood. The catheter tip may rest against the vessel wall.
  • Often a change of position of the upper body helps
  • Movement of the upper arm
  • Inhale while holding your breath for a short moment.
Port and catheter cannot be flushed under normal pressure. No blood can be drawn. Port catheter closure In all these cases, contact the family doctor immediately. The doctor will then discuss the necessary steps together with the patient.
Physical discomfort, pain and possibly swelling in the area of the shoulder, neck and arm Vein thrombosis
Pain and/or redness at the implantation site, fever or an unusual discharge at the injection site Infection of the port pocket
Burning pain after infusion of a drug, possibly in combination with blistering of the skin or swelling in the area of the port pocket Leaky system, the drug seeps into the surrounding tissue.
THESE COMPLICATIONS ARE EXTREMELY RARE, BUT CANNOT BE RULED OUT.

,

Problem Possible cause What can be done about it?
Rejection of the port by the body Incompatibility of the materials In all these cases, contact the family doctor immediately. The doctor will then discuss the necessary steps together with the patient.
Spontaneous slippage of the port Inappropriate fixation of the port during implantation
Twisting or slipping of the port as a result of unusual movements Inappropriate fixation of the port during implantation
Incision of the catheter between the collarbone and the first ribIndividual anatomical position.
Surgical technique.
The length of time a port system remains in place is largely determined by careful, sterile handling and regular port flushing.
The port system can remain in the body for several years and is surgically removed when it is no longer needed.
It is recommended to carry a special puncture needle with you for emergencies so that the port catheter system can be punctured at any time.
Ideally, the patient should always carry a suitable puncture needle with the patient pass.
Immediately after the operation, physically strenuous activities must be avoided at all costs.
Once the small incisions have healed, the normal way of life can be resumed.
If no needle is inserted, the port wearer can bathe, swim and do sports with the approval of their doctor, as they did before the implantation.
The port lies completely under the skin. A slight elevation of the skin is not visually noticeable.
However, the exact position of the port can be easily felt.
The small scars resulting from the implantation will become less and less noticeable over time.
No. In principle, however, we recommend that when you visit another doctor, you inform him or her immediately about the port, preferably by presenting the implantation card. This also applies to all diagnostic examinations and emergency treatments.
The port can remain in place for as long as is necessary to treat the disease.
It can then be easily removed again by a short surgical procedure under local anesthesia.
In some patients, it may be necessary to replace the port during long-term therapy, i.e. the old port is removed and replaced with a new one.
The port is made of pure TITAN.
The material properties of our ports have been extensively tested.
Since it is metal, the corresponding properties cannot be averted.
Test results show a harmlessness for possible MRI examinations, which behave within the parameters, see below (see also instructions for use):
MRI safety information

MR conditionally safe
Non-clinical tests have shown that the “Titan Port Chamber” is MR-conditionally safe. A patient with this product can be safely treated in a
MR system that meets the following conditions:
– Static magnetic field of 1.5 Tesla and 3 Tesla, with
– Maximum spatial field gradient of 12,900 G/cm (129 T/m)
– Maximum force product of 231,000,000 G2/cm (231 T2/m)
– Theoretically estimated maximum whole body averaged (WBA)
specific absorption rate (SAR) of 2 W/kg (normal operating mode).
Under the scanning conditions defined above, it is expected that the
“Titanium port chamber” a maximum temperature rise of less than
2.3 °C (2 W/kg, 1.5 Tesla) RF-induced temperature increase with a
background temperature increase of 1.4 °C (2 W/kg, 1.5 Tesla)
3.9 °C (2 W/kg, 3 Tesla) RF-induced temperature increase with a
background temperature increase of 2.0 °C (2 W/kg, 3 Tesla)
after 15 minutes of continuous scanning.
In non-clinical tests, the
image artifact caused by the product extends approximately 34.0 mm from the “titanium port chamber” when imaged with a gradient echo pulse sequence and
a 3 Tesla MR system.
It is extremely important that patients with an implanted port always carry a card with the relevant medical information.
This can be particularly important in emergencies.
Patients should therefore ask the operating doctor or one of the nurses to give them the patient pass.
This card should always be carried by the patient and presented when visiting the doctor or in the event of hospitalization
  • Aspiration: Withdrawal of blood from the catheter.
  • Implantation: Surgical insertion
  • Intravenous therapy: drug administration into the vein
  • NaCl 0.9: physiological saline solution, e.g. for rinsing the catheter
  • Parenteral nutrition: Administration of nutrients/electrolytes/vitamins/trace elements into the vein bypassing the digestive tract.
  • Peripheral veins: Veins in arms and legs
  • Bolus administration: single dose

This port catheter system in combination with suitable cannulae enables a high-pressure infusion of contrast media into the central circulatory system. The system is suitable to achieve a flow rate of 5ml/s at a maximum pressure of 21 bar (300 PSI). The pressure stability is tested accordingly and the indication of the suitable port systems or cannulas can be found with us, e.g. by a separate marking for the suitable articles.