title: Chest pain due to Pinch-off syndrome: radiological findings and endovascular rescue.
abstract: Port-a-cath is widely used as a route for administration of drugs in hematology and oncology patients and, recently, has been adapted also for hemodialysis patients. Major complications include infection, thrombosis, arrhythmia, and embolization. The Pinch-off-syndrome (POS) means the clavicle and the first rib compress the long-term central venous catheter. The reported incidence rate ranges from 1.4% to 4.1%. This syndrome can be recognized on chest radiography by observing a thinning of the catheter lumen through the passage between the clavicle and the first rib. Catheter fracture is a rare but potentially life-threatening complication that must be recognized and treated promptly. Management of dislodged ports includes percutaneous transcatheter retrieval, open thoracotomy retrieval and oral anticoagulant therapy. Among these techniques, percutaneous transcatheter retrieval is an easy, safe and efficient method. We report the successful percutaneous endovascular retrieval of dislodged intracardiac catheter, separated from its port, in a 58 year-old male patient who presented with chest pain.
authors.affiliation: Department of Vascular and Endovascular Surgery, University Federico II of Naples, Naples.
authors.forename: E
authors.initials: E
authors.lastname: Viviani
authors.affiliation: Department of Vascular and Endovascular Surgery, University Federico II of Naples, Naples.
authors.forename: A M
authors.initials: AM
authors.lastname: Giribono
authors.affiliation: Department of Vascular and Endovascular Surgery, University Federico II of Naples, Naples.
authors.forename: D
authors.initials: D
authors.lastname: Ferrara
authors.affiliation: Department of Vascular and Endovascular Surgery, University Federico II of Naples, Naples.
authors.forename: A
authors.initials: A
authors.lastname: Santagata
authors.affiliation: Department of Radiology, DIBIMEF, University Hospital P. Giaccone, University of Palermo, Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Narese
authors.affiliation: Department of Radiology, DIBIMEF, University Hospital P. Giaccone, University of Palermo, Palermo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Midiri
authors.affiliation: Department of Radiology, DIBIMEF, University Hospital P. Giaccone, University of Palermo, Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Albano
authors.affiliation: Department of Vascular and Endovascular Surgery, University Federico II of Naples, Naples.
authors.forename: M
authors.initials: M
authors.lastname: Porcellini
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000209:etiology*; D002968:Clavicle / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012272:Ribs / Q000000981:diagnostic imaging*; D016896:Treatment Outcome
keywords: Catheter embolization; Intravenous access device; Pinch-off syndrome; Snare catheter