CT Scans with BARD PowerPort: Safety and Guidelines for Contrast Injection

Computed Tomography - BARD PowerPort

Hello Dr.
Wang, I would like to inquire about the use of a BARD PowerPort during a computed tomography (CT) scan when injecting contrast agents.
The patient guide provided states that high-pressure injection of contrast agents is permissible with the PowerPort.
However, when I presented the identification card and wristband at the time of injection, the nurse questioned whether it was appropriate to use this implanted access device for the contrast injection.
I would like to understand if there are any concerns regarding the use of this access device for contrast injection, especially since my veins are small and difficult to locate, making the implanted device more convenient.
For future CT scans, should I avoid using the implanted access device, or does it not pose any issues? Additionally, can this type of access device be used for contrast injection during MRI scans, or are there specific limitations regarding its use in such situations? Thank you for your assistance, Dr.
Wang.

Miss Wang, 50~59 year old female. Ask Date: 2022/01/17

Dr. Wang Yifen reply Radiology

Hello,
1.
According to Ms.
Wang, a sales representative from BD Company, the POWERPORT implanted injection port can be used in conjunction with the SAFESTEP (safety non-coring needle) for percutaneous access to the port for treatments such as chemotherapy and drug infusion.
If a high-pressure, high-flow contrast agent injection is required, it is essential to first confirm that the injection port is a POWERPORT and use the specialized POWERLOC.
After puncturing the POWERPORT, it is necessary to confirm blood return and ensure a smooth flush before proceeding.
The flow rate and pressure must not exceed 300 PSI and 5 mL/second.
After the contrast agent injection, a 10 mL saline solution should be used to flush the lumen using a push-pause technique.
Once the examination is complete, if the patient will no longer undergo treatment, the line should be flushed with heparinized normal saline before removing the needle, and the line should be capped with positive pressure before needle removal.
Additionally, patients are encouraged to refer to the SDM video "What Vascular Access Options Are Available for Cancer Patients" at https://www.youtube.com/watch?v=AeGx4gMim9U.
Attached are the instructions for the POWERPORT (Bard PowerPort Implantable Injection Port), FDA Medical Device License No.
024780, link: https://info.fda.gov.tw/mlms/H0001D3.aspx?LicId=06024780 and the POWERLOC (Bard PowerLoc Safety Infusion Set) instructions, FDA Medical Device License No.
025145, link: https://info.fda.gov.tw/mlms/H0001D3.aspx?LicId=06025145.
2.
Due to the use of this artificial vascular access, it is necessary to use a specialized injection needle, which may not be routinely stocked by the radiology departments in every hospital.
For hospitalized patients, the specialized needle can be placed in the ward before proceeding to the radiology department for examination.
For outpatient patients, it is recommended that the outpatient physician prescribe the specialized needle when ordering the contrast agent for a CT scan and confirm that the specialized needle can be obtained from the radiology department.
If the specialized needle cannot be obtained before the examination, only traditional contrast agent injection methods can be used, which involve accessing peripheral veins.
3.
This artificial vascular access can also be used for injecting MRI contrast agents during MRI scans.
Please refer to the above information, and I wish you health and safety.

Reply Date: 2022/01/17

More Info

When it comes to undergoing a CT scan with a BARD PowerPort for contrast injection, there are several important considerations regarding safety and guidelines. The BARD PowerPort is a type of implanted port that allows for easy access to the bloodstream, which can be particularly beneficial for patients who require frequent blood draws or injections, such as those undergoing chemotherapy or other treatments.

Safety of Using BARD PowerPort for CT Scans
1. Compatibility with Contrast Agents: The BARD PowerPort is designed to be compatible with various types of contrast agents used in CT scans. However, it is essential to ensure that the healthcare team is aware of the port's presence and its specifications. The port should be flushed and checked for patency before use to ensure that it can handle the high-pressure injection typically required for CT contrast.

2. Identification and Communication: As you mentioned, providing identification cards and wristbands is crucial. This helps the medical staff confirm that they are using the correct device and that it is functioning properly. If there are any uncertainties, it is always best to communicate openly with the nursing staff or radiologist about the use of the PowerPort for contrast injection.

3. Potential Risks: While using a PowerPort is generally safe, there are risks associated with any intravenous access, including infection, thrombosis, or port malfunction. It is important to monitor for any signs of complications, such as swelling, redness, or pain at the site of the port.

Guidelines for Future CT Scans
If you have a PowerPort and require future CT scans, it is typically acceptable to use the port for contrast injections. However, if there are any concerns about the port's integrity or if the healthcare team feels that the peripheral veins are more suitable for the injection, they may opt to use those instead. The decision will depend on the specific circumstances, including the size and condition of your veins and the urgency of the imaging.

Use of PowerPort in MRI
Regarding the use of the BARD PowerPort during MRI scans, it is crucial to note that not all implanted devices are MRI-compatible. The PowerPort is generally made of materials that are safe for MRI; however, the specific model and manufacturer guidelines should be consulted.
1. MRI Safety: Before undergoing an MRI, inform the technician about your PowerPort. They will check if it is safe to use during the scan. If the port is MRI-compatible, it can be used for contrast injections during the MRI procedure as well.

2. Limitations: If the PowerPort is not MRI-compatible, alternative methods for contrast administration may need to be considered. In such cases, peripheral IV access may be utilized instead.

Conclusion
In summary, using a BARD PowerPort for contrast injection during a CT scan is generally safe and can facilitate the process, especially if peripheral veins are difficult to access. Always ensure that the healthcare team is informed about your port and its specifications. For MRI scans, check compatibility with the specific device model to ensure safety. Open communication with your healthcare providers is key to addressing any concerns and ensuring a smooth imaging process. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice.

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