PowerPort vs. Other Port Catheters — Key Differences

Understanding Different Types of Venous Access Devices

Patients requiring long-term intravenous access for chemotherapy, nutrition, or repeated blood draws have several device options. Implantable ports — placed entirely under the skin — offer the advantage of no external tubing and can remain in place for years. Tunneled catheters such as Hickman and Broviac catheters exit through the skin and require daily maintenance. Peripherally inserted central catheters (PICC lines) are placed through arm veins and are intended for shorter-term use (weeks to months). The choice between these devices involves trade-offs in convenience, maintenance burden, infection risk, and longevity.

The Bard PowerPort is specifically a power-injectable port — meaning it is engineered to withstand the high injection pressures of CT contrast administration (up to 5 mL/sec) as well as standard infusion. This power-injection capability was a differentiating marketing feature. The polyurethane catheter tubing was chosen to provide the structural rigidity needed to withstand power injection forces. Competing silicone catheters in standard implantable ports are not power-injectable at standard pressures, though power-injectable silicone port catheters have since been developed and marketed.

Hickman Catheter

Hickman catheters (and the related Broviac catheter) are tunneled, externally-exiting central venous catheters made from silicone tubing. The catheter is tunneled under the chest skin but exits through the skin, with the external portion requiring a sterile dressing and daily heparin flushing by the patient or caregiver. Because there is no implanted port, there is no subcutaneous reservoir and no access needle required. Hickman catheters use silicone tubing throughout — they do not experience the ESC fracture mechanism that affects polyurethane PowerPort catheters. However, their external exposure creates different risks: higher infection rates from the skin exit site and accidental dislodgement.

Silicone Mediport and Other Implantable Ports

Several manufacturers produce implantable ports with silicone catheter tubing — including certain Vortex Port and Titanium Port products from AngioDynamics and others. These silicone-catheter ports provide the same subcutaneous convenience as the PowerPort — no external hardware, accessed only when needed — while using catheter tubing that does not degrade through the ESC mechanism that fractures polyurethane. Plaintiffs in the PowerPort litigation argue that the existence of silicone-catheter implantable ports demonstrates that a safer design alternative was available and feasible when Bard chose to use polyurethane.

PICC Lines

Peripherally inserted central catheters (PICCs) are inserted through a peripheral arm vein (typically the basilic or cephalic vein) and advanced until the tip rests in the superior vena cava. They are intended for short to medium-term use (weeks to several months) and are commonly used in patients who need central venous access but do not warrant a permanent implantable port. PICCs use polyurethane or silicone tubing; polyurethane PICC fractures have been reported but are generally less common than PowerPort fractures due to shorter implant durations. PICCs exit through the arm skin and require maintenance. They do not involve the clavicle-first rib pinch-off mechanism that is a primary driver of PowerPort fracture because the insertion site and catheter routing are different.