title: Pinch-off syndrome.
abstract: Subclavian venous catheterization was previously frequently performed, but because of life-threatening complications such as hemothorax, pneumothorax, mediastinal hematoma, and myocardial injury, its use has become less common. However, this practice has some advantages in patient mobility, secured dressing, and rapidity and adequacy of vascular access. In some situations where patient comfort is an especially important consideration, such as with totally implantable venous port insertion for chemotherapy, the subclavian route can be a good choice if an experienced and well-trained faculty is available. The authors have had recent experience with pinch-off syndrome-in other words, spontaneous catheter fracture-in 3 patients who had undergone venous port implantation through the right subclavian route. Through these cases, we intend to review the dangers of subclavian venous catheterization, the causes of pinch-off syndrome, and its clinical presentation, progress, treatments, and prevention.
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.
authors.forename: Jin-Beom
authors.initials: JB
authors.lastname: Cho
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Park
authors.forename: Ki-Young
authors.initials: KY
authors.lastname: Sung
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Baek
authors.forename: Jun-Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Do-Sang
authors.initials: DS
authors.lastname: Lee
keywords: Implantable venous port; Pinch off syndrome; Spontaneous catheter fracture; Subclavian venous catheterization
references.citation: AJR Am J Roentgenol. 1978 Mar;130(3):541-8
references.pmid: 415566
references.citation: JPEN J Parenter Enteral Nutr. 1985 Nov-Dec;9(6):754-7
references.pmid: 4068197
references.citation: Am J Surg. 1984 Nov;148(5):633-6
references.pmid: 6496853
references.citation: Intensive Care Med. 1997 Aug;23(8):916-9
references.pmid: 9310813
references.citation: Radiology. 1990 Nov;177(2):353-6
references.pmid: 2217768
references.citation: Artif Organs. 1994 Apr;18(4):293-7
references.pmid: 8024478
references.citation: Am Surg. 2004 Jul;70(7):635-44
references.pmid: 15279190
references.citation: Clin Nutr. 1998 Apr;17(2):89-91
references.pmid: 10205324
references.citation: Crit Care. 2006;10(6):R162
references.pmid: 17112371