title: Totally implantable catheter embolism: two related cases.
abstract: OBJECTIVE
  Long-term totally implantable catheters (e.g. Port-a-Cath) are frequently used for long-term venous access in children with cancer. The use of this type of catheter is associated with complications such as infection, extrusion, extravasation and thrombosis. Embolism of catheter fragments is a rare complication, but has potential for morbidity. The aim here was to report on two cases in which embolism of fragments of a long-term totally implantable catheter occurred.
  
  
  METHODS
  Case series study at Hospital do Servidor Público Estadual, São Paulo.
  
  
  METHODS
  Retrospective review of catheter embolism in oncological pediatric patients with long-term totally implantable catheters.
  
  
  RESULTS
  The first patient was a 3-year-old girl diagnosed with stage IV Wilms' tumor. Treatment was started with the introduction of a totally implantable catheter through the subclavian vein. At the time of removal, it was realized that the catheter had fractured inside the heart. An endovascular procedure was necessary to remove the fragment. The second case was a boy diagnosed with stage II Wilms' tumor at the age of two years. At the time of removal, it was noticed that the catheter had disconnected from the reservoir and an endovascular procedure was also necessary to remove the embolized catheter.
  
  
  CONCLUSIONS
  Embolism of fragments of totally implantable catheters is a rare complication that needs to be recognized even in asymptomatic patients.
authors.affiliation: Pediatric Surgery Service, Hospital do Servidor Público Estadual, São Paulo, Brazil. rodrigocribeiro@uol.com.br
authors.forename: Rodrigo Chaves
authors.initials: RC
authors.lastname: Ribeiro
authors.forename: Aurea Cristina Ferreira
authors.initials: AC
authors.lastname: Monteiro
authors.forename: Quirino Cavalcante
authors.initials: QC
authors.lastname: Menezes
authors.forename: Sérgio Tomaz
authors.initials: ST
authors.lastname: Schettini
authors.forename: Sonia Maria Rossi
authors.initials: SM
authors.lastname: Vianna
mesh_terms: D006328:Cardiac Catheterization; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002675:Child, Preschool; D004617:Embolism / Q000209:etiology*; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy; D008297:Male; D012189:Retrospective Studies; D013350:Subclavian Vein / Q000293:injuries*; D009396:Wilms Tumor / Q000628:therapy