Totally implantable catheter embolism: two related cases.
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.
Ribeiro
Rodrigo Chaves
RC
Pediatric Surgery Service, Hospital do Servidor Público Estadual, São Paulo, Brazil. rodrigocribeiro@uol.com.br
Monteiro
Aurea Cristina Ferreira
AC
Menezes
Quirino Cavalcante
QC
Schettini
Sérgio Tomaz
ST
Vianna
Sonia Maria Rossi
SM
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