Costoclavicular pinching: a complication of long-term central venous catheters. A report of three cases.
In the course of 1994-1995 we found three nearly identical cases involving fracture of polyurethane catheters from subcutaneous implantable vascular ports. This resulted in complications: leakage of drugs and infusions and thereby soft tissue damage. The leakage occurred in the costoclavicular space in all instances. We assume that the catheters have been subjected to repeated pinching, resulting in material fatigue. In order to eliminate the risk of this serious complication, the subclavian route should be avoided and preference given to the approach via the internal jugular vein.
Dept. of Anaesthesia, Telemark Central Hospital, Porsgrunn, Norway.
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Waagsbø
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D002968:Clavicle; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D004868:Equipment Failure; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005950:Glucose Solution, Hypertonic / Q000008:administration & dosage / Q000627:therapeutic use; D006427:Hemin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007601:Jugular Veins; D008297:Male; D011140:Polyurethanes / Q000737:chemistry; D017094:Porphyrias, Hepatic / Q000188:drug therapy; D012004:Rectal Neoplasms / Q000188:drug therapy; D012272:Ribs; D012307:Risk Factors; D013314:Stress, Mechanical; D013350:Subclavian Vein; D013499:Surface Properties
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D005950:Glucose Solution, Hypertonic; D011140:Polyurethanes; D006427:Hemin; D004317:Doxorubicin; D005472:Fluorouracil