Totally implanted venous access ports are excellent devices for delivering chemothera peutic agents and prolonged intravenous infusions in patients with cancer. Catheter fracture and embolization are rare and potentially serious complications of these widely used devices. Retrieval of the embolized fragment is generally indicated but may not be possible. The authors report three cases of catheter embolization in their center over a period of 9 years. Catheter "pinch-off," fracture, embolization, and retrieval are discussed.
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References
1.
Lokich JL, Bothe A. Jr, Benotti P., et al: Complications and management of implanted venous access catheters . J Clin Oncol3:710-717, 1985.
2.
Ingle RJ: Rare complications of vascular access devices. Sem Oncol Nursing11:184-193, 1995.
3.
McMenamin EM : Catheter fracture: A complication in venous access devices. Cancer Nursing16:464-467, 1993.
4.
Rubenstein RB , Smith RT, Strauss AG, et al: Hickman catheter separation. JPEN9:754-757, 1985.
5.
Scott WL: Complications associated with central venous catheters: A survey. Chest94:1221-1224, 1988.
6.
Lafreniere R. : Indwelling subclavian catheters and a visit with the "pinched-of" sign. J Surg Oncol47:261-264, 1991.
7.
Fisher RG, Ferreyro R.: Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies. Am J Roentgenol130:541-548, 1978.
8.
Schlangen JT , Debets Jmh, Wils JA: The "pinch-off phenomenon": A radiological symptom for potential fracture of an implanted permanent subclavian catheter system. Eur J Radiol20:112-113, 1995.
9.
Nace CS, Ingle RJ: Central venous catheter "pinch-off" and fracture: A review of two under-recognized complications. Oncol Nursing Forum20:1227-1236, 1993.
10.
Aitken DR, Minton JP: The "pinch-off sign": A warning of impending problems with permanent subclavian catheters. Am J Surg148:633-636, 1984.
11.
Hinke DH, Zandt-Stastny DA, Goodman LR, et al: Pinch-off syndrome: A complication of implantable subclavian venous access devices. Radiology177:353-356, 1990.
12.
Prager D., Hertzberg RW: Spontaneous intravenous catheter fracture and embolization from an implanted venous access port and analysis by scanning electron microscopy. Cancer60:270-273, 1987.
13.
Bauch TD, Stoughton TL, Pearl W.: Breakage of an embolized intravascular catheter fragment: A complication of nonsurgical transvenous retrieval. JPEN16:175-177, 1992.
14.
Carr ME Jr: Catheter embolization from implanted venous access devices: Case reports. Angiology40:319-323, 1989.
