[Catheter fracture and pulmonary embolization of the distal fragment: a rare complication of the totally implantable venous access port].
BACKGROUND
Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries.


METHODS
We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory.


CONCLUSIONS
We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it.
Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc. Electronic address: r-houssam@hotmail.com.
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Rebahi
Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
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AG
El Adib
Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
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Y
Mouaffak
Service de cardiologie, hôpital Ibn Tofail, CHU Mohammed VI, rue Al Moustachfa, Gueliz 40000, Marrakech, Maroc.
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El Hattaoui
Unité de cardiologie interventionnelle, clinique internationale de Marrakech, route de l'Aéroport, Bab Ighli 40000, Marrakech, Maroc.
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Chaara
Service d'onco-radiothérapie, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
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Sadek
Service d'onco-radiothérapie, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
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M
Khouchani
Service d'onco-radiothérapie, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
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Mahmal
Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
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Younous
D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D013902:Radiography, Thoracic; D062666:Vascular Access Devices / Q000009:adverse effects*
Artères pulmonaires; Catheter fracture; Chambre à cathéter implantable; Migration; Pulmonary embolization; Rupture de cathéter; Totally implantable venous access port