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Sarzo G, Finco C, Zustovich F, Parise P, Savastano S, Degregori S, Vecchiato M, Merigliano S. Early Rupture of Subclavian Vein Catheter: A Case Report and Literature Review. J Vasc Access 2018; 5:39-46. [PMID: 16596539 DOI: 10.1177/112972980400500109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Prolonged venous access devices (PVADs) have become indispensable in antiblastic protocols for the treatment of cancer patients, in anti-infection protocols for acquired immunodeficiency syndrome (AIDS) patients and in the management of chronic malabsorption syndromes. Using these catheters carries the risk of several complications, and some are potentially lethal, for example, cardiac embolization of catheter fragments. Rupture is a complication almost exclusive to catheters positioned percutaneously: after using this technique, device malfunction can occur due to catheter kinking after its excessively medial introduction in the subclavian vein. The early recognition of any pinch-off sign (POS) is fundamental in preventing catheter rupture that frequently follows this complication. Other factors can be involved in early rupture, for example, excessive force on a syringe used to clear a catheter that shows early signs of malfunction, or a strength defect in the materials used in the catheter construction. This report describes an early rupture case of an initially correctly positioned catheter and reviews 20 such cases in the recent literature.
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Affiliation(s)
- G Sarzo
- Department of Medical and Surgical Sciences, 3rd General Surgery Clinic, S. Antonio Hospital, University of Padova, Padova, Italy.
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Kim Y. Catheter Fracture of a Totally Implantable Venous Device Due to Pinch Off Syndrome in Breast Cancer: A Case Report. KOSIN MEDICAL JOURNAL 2016. [DOI: 10.7180/kmj.2016.31.2.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Yoonseok Kim
- Department of Surgery, Busan Adventist Hospital, Busan, Korea
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Fracture and migration of implantable venous access port catheters: Cause analysis and management of 4 cases. ACTA ACUST UNITED AC 2015; 35:763-765. [PMID: 26489636 DOI: 10.1007/s11596-015-1504-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/17/2015] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate the causes and managements of the fractures and migrations of the implantable venous access port catheter (IVAPC). The fracture or migration of IVAPC occurred in 4 patients who were treated between May 2012 and January 2014 in Union Hospital, Wuhan, China. The port catheter leakage was found in 2 cases during drug infusion. Catheters that dislodged to the superior vena cava and right atrium were confirmed by port angiogram. The two dislodged catheters were successfully retrieved by interventional procedures. Catheter fracture occurred in two cases during port removal. One catheter was eventually removed from the subclavian vein through right clavicle osteotomy and subclavian venotomy, and the other removed by external jugular venotomy. Flushing the port in high pressure and injury of the totally implantable venous access port (TIVP) during implantation are usually responsible for catheter displacement. Interventional retrieval procedure can be used if the catheter dislodges to the vena cava and right atrium. Catheter fracture may occur during removal if clipping syndrome occurs or the catheter is sutured very tight during implantation.
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Faraj W, Zaghal A, El-Beyrouthy O, Kutoubi A. Complete Catheter Disconnection and Migration of an Implantable Venous Access Device: The Disconnected Cap Sign. Ann Vasc Surg 2010; 24:692.e11-5. [DOI: 10.1016/j.avsg.2010.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 09/28/2009] [Accepted: 02/08/2010] [Indexed: 10/19/2022]
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Surov A, Wienke A, Carter JM, Stoevesandt D, Behrmann C, Spielmann RP, Werdan K, Buerke M. Intravascular Embolization of Venous Catheter—Causes, Clinical Signs, and Management: A Systematic Review. JPEN J Parenter Enteral Nutr 2009; 33:677-85. [PMID: 19675301 DOI: 10.1177/0148607109335121] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alexey Surov
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
| | - Andreas Wienke
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
| | - Justin M. Carter
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
| | - Dietrich Stoevesandt
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
| | - Curd Behrmann
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
| | - Rolf-Peter Spielmann
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
| | - Karl Werdan
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
| | - Michael Buerke
- From the Department of Radiology, Department of Biology, and Department of Cardiology and Intensive Care Medicine, Martin Luther University, Halle, Germany
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Crisinel M, Mahy S, Ortega-Debalon P, Buisson M, Favre JP, Chavanet P, Piroth L. Incidence, prévalence et facteurs de risque de survenue d’une première complication infectieuse sur chambres à cathéter implantables. Med Mal Infect 2009; 39:252-8. [DOI: 10.1016/j.medmal.2008.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 10/02/2008] [Accepted: 11/14/2008] [Indexed: 10/21/2022]
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Espiritu JD, Stolar CG. Pulmonary hypertension due to a retained totally implantable venous access device fragment. Chest 2007; 131:1574-6. [PMID: 17494809 DOI: 10.1378/chest.06-1792] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Pulmonary hypertension can occur from obstruction of the distal pulmonary arteries by thrombus, ova and parasites, and foreign material. We report a 62-year-old patient who had fatal pulmonary hypertension from an 8-cm fragment of a totally implantable venous access device (TIVAD) retained in the pulmonary artery. Despite long-term therapeutic anticoagulation, pulmonary angiography showed chronic occlusion of the posterior branch of the superior right pulmonary artery with paucity of distal vasculature consistent with an old right upper lobe pulmonary embolus. Retrieval of the fragment was attempted via pulmonary artery catheterization techniques but was unsuccessful. In conclusion, progressive pulmonary hypertension may result from retention of a TIVAD fragment in a central pulmonary artery despite therapeutic anticoagulation. Worsening pulmonary hypertension may have been due to partial obstruction of the main pulmonary arteries, resulting in recurrent thromboembolism or in situ thrombosis, and remodeling of small distal pulmonary arteries.
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Affiliation(s)
- Joseph D Espiritu
- Division of Pulmonary, Critical Care, and Sleep Medicine, Saint Louis University Hospital, 3635 Vista Avenue at Grand Blvd., Saint Louis, MO 63110-0250, USA.
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