title: Catheter fracture and embolization associated with arm implantation of the cook vital port.
abstract: OBJECTIVE
  To determine the frequency of arm port catheter fracture and embolization related to the Cook Vital Port Mini Titanium.
  
  
  METHODS
  A retrospective audit of our Cerner Radiology Information System was performed between June 1, 2006, and June 30, 2011, to determine the number of Cook arm venous ports implanted and the frequency of foreign body retrievals related to catheter fracture for these arm ports.
  
  
  RESULTS
  A total of 691 arm implantations of the Cook Vital Port during the 5-year time frame were analysed. Eleven of these patients (1.6%) required intravenous foreign body retrieval in the interventional radiology suite related to catheter fracture and embolization. Three of these fractured catheters were retrieved from the peripheral venous system upstream of the pulmonary circulation, whereas 8 embolized to the pulmonary arteries. All were successfully extracted with an intravenous snare by interventional radiology.
  
  
  CONCLUSIONS
  We discovered a 1.6% frequency of catheter fracture and embolization associated with arm implantation of the Cook Vital Port. All the catheters fractured at the vein entry site and did not detach from the port housing. The cause for catheter fracture and embolization is uncertain. Pulmonary embolization of the fractured catheters puts the patients at risk for possible further complications. No patients had ancillary complications related to catheter embolization or to catheter extraction procedures. Further investigation is required in an attempt to determine the circumstances that may result in catheter fracture and embolization related to this venous access device.
authors.affiliation: Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada. brent.burbridge@usask.ca
authors.forename: Brent
authors.initials: B
authors.lastname: Burbridge
authors.forename: Grant
authors.initials: G
authors.lastname: Stoneham
authors.forename: Peter
authors.initials: P
authors.lastname: Szkup
authors.forename: Rob
authors.initials: R
authors.lastname: Otani
authors.forename: Stefan
authors.initials: S
authors.lastname: Kriegler
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000098:blood supply / Q000000981:diagnostic imaging; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000706:statistics & numerical data*; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging*; D011859:Radiography; D015642:Radiology, Interventional / Q000379:methods; D012189:Retrospective Studies