Port‑a‑Cath Maintenance Recommendations and Occlusion Management

Guideline‑Based Maintenance

• The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines recommend that subcutaneous ports not in active use be flushed every four weeks (monthly) with normal saline — a conservative, manufacturer‑aligned approach. 1
• Routine flushing of ports should be performed with normal saline, as endorsed by both the ESMO guideline and supporting literature. 1, 2

Complication Incidence

• Catheter occlusion is the most common port‑related complication, occurring in approximately 1.9 % of patients. 3

Management of Complete Occlusion

• The American College of Radiology (ACR) guidelines advise that complete catheter occlusion be treated with thrombolytic therapy using recombinant tissue‑type plasminogen activator (rTPA) at a dose of 2 mg/2 mL; this restores catheter function in about 90 % of cases within 2 hours. 3