[Fracture and embolization of a central venous port catheter without prior compression between the clavicle and the 1st rib].
A central venous port catheter inserted infraclavicularily via the subclavian route may be compressed by the clavicle and the adjacent first rib. It's appearance on chest x-ray has been previously described as the 'pinch-off phenomenon' and requires the removal of the catheter due to a significant risk of fracture. We report the case of a catheter fracture without prior evidence of pinch-off. The free catheter fragment was embolized into the right atrium and caused pericardial effusion. Percutaneous removal of the fragment was attempted but failed and thus open heart surgery with a cardiopulmonary bypass was required. The myocardial lesion caused by the catheter was sutured.
Institut für Radiologie I, Allgemeines öffentliches Krankenhaus Wels der Barmherzigen Schwestern vom Heiligen Kreuz, Wels, Osterreich.
F X
FX
Lenglinger
P
P
Hartl
A
A
Kirchgatterer
G M
GM
Lenglinger
C
C
Baldinger
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology*; D013902:Radiography, Thoracic; D013997:Time Factors; D014057:Tomography, X-Ray Computed