- Meeting abstract
- Open Access
A complication of port-a-cath: disconnection and migration of central venous catheter to pulmonary artery. A case report.
Critical Ultrasound Journal volume 4, Article number: A24 (2012)
A 50 year old woman, with breast cancer undergoing chemotherapy. Login to removal because of the disconnection between the catheter and the subcutaneous port, diagnosed in routine check. In this case the X-ray showed the disconnection between the catheter and the subcutaneous port. And the consequent migration of the catheter, through cardiac cavities, into the pulmonary artery. Embolized catheter was removed by interventional radiology, under local anesthesia and intravenous sedation.The retrieval of the fragment was performed successfully using a snare catheter passed through the right femoral vein.
The central venous cannulation and placement of permanent vascular access is a common technique in cancer patients. This is an invasive procedure, non-therapeutic or curative in itself, which can lead to serious complications, even death.
The iconography of this case demonstrates a mechanical complication, potentially severe and rare placement of a port-a-cath. Embolized catheters can be removed by interventional radiology without significant adverse affects. The patient recovered without complications.
Subramaniam A, Kim KH, Bryant SA, Kimball KJ, Huh WK, Straughn JM, Estes JM, Alvarez RD: Incidence of mechanical malfunction in low-profile subcutaneous implantable venous access devices in patients receiving chemotherapy for gynecologic malignancies. Gynecol Oncol 2011,123(1):54–7. Epub 2011 Jul 13 10.1016/j.ygyno.2011.06.012
Heibl C, Trommet V, Burgstaller S, Mayrbaeurl B, Baldinger C, Koplmüller R, Kühr T, Wimmer L, Thaler J: Complications associated with the use of Port-a-Caths in patients with malignant or haematological disease: a single-centre prospective analysis. Eur J Cancer Care (Engl) 2010,19(5):676–81. Epub 2009 Aug 25 10.1111/j.1365-2354.2009.01115.x
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(6):677–85. Epub 2009 Aug 12 10.1177/0148607109335121
Debourdeau P, Zammit C, Pavic M, Bensaid B, Farge-Bancel D: Venous thromboembolism associated with long-term use of central venous catheters in cancer patients]. Rev Med Interne 2007,28(7):471–83. Epub 2007 Apr 19 10.1016/j.revmed.2007.03.002