Emergency percutaneous retrieval of a silicone port catheter fragment in pinch-off syndrome by means of an Amplatz gooseneck snare.
Rupture of a silicone Port-a-Cath catheter may occur, especially with costoclavicular pinch-off syndrome (POS), which is a typical consequence of fatigue when the catheter is introduced in the subclavian vein too medially. This case report describes the percutaneous retrieval of a fractured silicone port catheter fragment, which had migrated into the internal jugular vein. Extraction was complicated by the presence of an internal jugular vein stenosis and the fact that the catheter fragment was looped upon itself. Several retrieval devices failed before an Amplatz gooseneck snare finally allowed retrieval of the fragment. We recommend this device for extraction of silicone port catheter fragments. Rerupture of the port catheter occurred 7 months after surgical reinsertion at the same infraclavicular site, as a consequence of constant compression by POS. Alternative approaches should be used after catheter failure due to POS.
Institute of Diagnostic Radiology, Inselspital, University Hospital Bern, 3010 Bern, Switzerland. hans-peter.dinkel@insel.ch
Hans-Peter
HP
Dinkel
Manfred
M
Muhm
Aristomenis K
AK
Exadaktylos
Hanno
H
Hoppe
Jürgen
J
Triller