Percutaneous retrieval of dislodged totally implantable central venous access system in 92 cases: experience in a single hospital.
OBJECTIVE
To investigate the clinical presentation of dislodged totally implantable central venous access system (central venous port-catheter) fragments and the efficacy and safety of percutaneous retrieval of them in our hospital.


METHODS
Ninety-two cancer patients, mean age of 53.8 years old with 51.1% male, were enrolled from January 2005 to March 2007. They were referred to our catheterization laboratory for retrieval of fractured central venous port-catheter in our hospital. All patients were followed in the outpatient department for at least 1 month after surgical insertion. The characteristics of disrupted central venous port-catheter were recorded. The procedure-related clinical condition was evaluated.


RESULTS
The most common presentation of central venous port-catheter dislodgement is irrigation resistance to infusion (51/92). The most common location of fractured fragments is between superior vena cava and right atrium (i.e. proximal end remained in superior vena cava and distal end in right atrium) (22/92). The most common fracture site of the catheter is at the anastomosis between injection port and catheter (77/92). The retrieval set used mostly is loop snare. The success rate of the percutaneous retrieval of dislodged fragment was 97.8% and the complication rate was 3.3% only.


CONCLUSIONS
The faulty connection between catheter and injection port contributes mainly to dislodgement of central venous port-catheter. Percutaneous retrieval of dislodged catheter is a highly successful, safe and efficient method.
Cheng
Cheng-Chung
CC
Division of Cardiology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Tsai
Tsung-Neng
TN
Yang
Chung-Chi
CC
Han
Chih-Lu
CL
D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D020878:Device Removal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D015642:Radiology, Interventional / Q000379:methods; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome