Fracture and migration of implantable venous access port catheters: Cause analysis and management of 4 cases.
This study aimed to investigate the causes and managements of the fractures and migrations of the implantable venous access port catheter (IVAPC). The fracture or migration of IVAPC occurred in 4 patients who were treated between May 2012 and January 2014 in Union Hospital, Wuhan, China. The port catheter leakage was found in 2 cases during drug infusion. Catheters that dislodged to the superior vena cava and right atrium were confirmed by port angiogram. The two dislodged catheters were successfully retrieved by interventional procedures. Catheter fracture occurred in two cases during port removal. One catheter was eventually removed from the subclavian vein through right clavicle osteotomy and subclavian venotomy, and the other removed by external jugular venotomy. Flushing the port in high pressure and injury of the totally implantable venous access port (TIVP) during implantation are usually responsible for catheter displacement. Interventional retrieval procedure can be used if the catheter dislodges to the vena cava and right atrium. Catheter fracture may occur during removal if clipping syndrome occurs or the catheter is sutured very tight during implantation.
Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Shu-Ping
SP
Xiao
Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. herrxiong@126.com.
Bin
B
Xiong
Department of Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University, Shanghai, 200127, China.
Jun
J
Chu
Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Xiao-Fang
XF
Li
Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Qi
Q
Yao
Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Chuan-Sheng
CS
Zheng
D000792:Angiography; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000379:methods; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D013536:Suture Techniques; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult
catheter migration; implantable venous access port; intervention; nurse care