title: [A rare complication of permanent venous access: constriction, fracture and embolization of the catheter].
abstract: The pinch off syndrome due to squeezing of the implanted catheter is a rare complication of permanent venous access devices (0.1 to 1% of the cases). The cause is a mechanical catheter's compression in the costo-clavicular space, when implanted too medially in the subclavian vein. In case of lack of venous reflux or injection difficulties, sometimes complicated by local pain, a radiological control must be obtained to demonstrate signs of compression or beginning of fracture. Significant damage to the system is shown be extravasation of radioopaque contrast medium. The suspicion of catheter damage justifies early replacement of the system to avoid right heart or pulmonary artery embolism. The electron microscopic scanning tends to prove that the catheter's rupture is caused by a fatigue process.
authors.affiliation: Service de Chirurgie, Hôpital des Cadolles, Neuchâtel.
authors.forename: Y
authors.initials: Y
authors.lastname: Groebli
authors.forename: P
authors.initials: P
authors.lastname: Wuthrich
authors.forename: P
authors.initials: P
authors.lastname: Tschantz
authors.forename: P
authors.initials: P
authors.lastname: Beguelin
authors.forename: D
authors.initials: D
authors.lastname: Piguet
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D019544:Equipment Failure Analysis; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy; D008854:Microscopy, Electron; D011859:Radiography; D013499:Surface Properties
chemical_list: D000970:Antineoplastic Agents
vernacular_title: Une complication rare des accès veineux permanents: laminage, fracture et embolisation du catheter.