Fractures of Totally Implantable Central venous Ports: More than Fortuity. A Three-Year Single Center Experience

Balsorano, Paolo; Galducci, Giulia; Fanti, Ilaria De; Evans, Samuel K.; Gaudio, Angelo Raffaele De; Pelagatti, C

doi:10.5301/jva.5000261

Cited by 17 publications

(21 citation statements)

References 26 publications

(26 reference statements)

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“…We performed "out-of-plane" puncture of the femoral vein, which is reported to be a risk factor for IJV puncture. A retrospective analysis of 338 removed ports reported that out-of-plane" ultrasound-guided puncture of the IJV was significantly associated with catheter ruptures, which is invariably associated with a more vertical pathway and a narrower angle at the entry point into the vein wall (Balsorano et al 2014).…”

Section: Discussionmentioning

confidence: 99%

Femoral placement of a totally implantable venous access port with spontaneous catheter fracture: case report

et al. 2020

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Background: The incidence of catheter fracture after standard positioning of a totally implantable venous access port (TIVAP) is reported to be 1.1%-5.0%; however, the incidence of catheter fracture after TIVAP implantation at a femoral site remains unclear. Case presentation: In a 30-year-old man with angiosarcoma of the right atrium, tumor embolism was observed from the left brachiocephalic vein to the superior vena cava. A TIVAP was implanted in the right femur. A catheter fracture was spontaneously observed after 7 months. Conclusions: To the best of our knowledge, this is the first case of catheter fracture in a TIVAP implantation at a femoral site.

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Section: Discussionmentioning

confidence: 99%

Femoral placement of a totally implantable venous access port with spontaneous catheter fracture: case report

et al. 2020

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“…15 Balsorano conducted a study specifically designed to verify the integrity of catheters after removal, whether because of malfunction or because treatment had been terminated, and found that the type of catheter and use of "heterodox" accesses were related to microruptures. 16 The hospital in which the TICs were implanted in the cases described here is a referral center for cancer treatment that has implanted around 100 TICs per year since 2011. Over this period, complications such as local infection, hematoma, thrombosis at the catheter site and exteriorization of the catheter reservoir occurred in an occasional and rare manner, without causing serious risk or morbidity to patients, although we do not have precise data for all patients.…”

Section: Discussionmentioning

confidence: 99%

Desconexão de cateter para quimioterapia: uma complicação rara?

Oliveira

Filho²

2017

J. vasc. bras.

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ResumoA utilização de cateteres totalmente implantáveis no tratamento quimioterápico constitui uma necessidade que acarreta o risco de múltiplas complicações, algumas inerentes à inserção do dispositivo e outras relacionadas ao próprio cateter. Relatamos três casos nos quais o cateter apresentou-se desacoplado de seu respectivo reservatório. No primeiro caso, ocorreu a desconexão do cateter de seu respectivo reservatório, e nos outros dois casos, verificou-se a fragmentação do cateter. Em todos os casos, foi necessária a retirada endovascular do cateter. Tal desfecho é apontado como raro, mas costuma estar presente na maioria das revisões e traz consigo o risco de complicações graves, ainda que frequentemente seja assintomático. É desejável o acompanhamento de pacientes que possuem tais cateteres a fim de que se possa detectar precocemente tais complicações e compreender os fatores que determinam o aparecimento dessas situações.

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“…A catheter fracture with subsequent migration is a rare complication after the TIVAP implantation [ 5 ]. But, rupture of the catheter is potentially severe complication [ 2 ]. The causes of a catheter fracture of the TIVAP are unclear, but might include the following [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…A totally implantable venous access port (TIVAP) plays a crucial role in the treatment of patients in oncology [ 1 ]. But, among the late mechanical complications, lesions of the catheter wall represent a rare but potentially severe condition, whose natural history can vary from a partial rupture or catheter malfunction to a complete catheter fracture with embolization of the ruptured fragment [ 2 ]. Mostly, transection and embolization of a TIVAP, so called “Pinch-off” syndrome (POS), is a rare complication of a TIVAP via subclavian vein (SCV) and the incidence is reported to be 1.1–5.0 % (%) of patients with TIVAP via the SCV [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Spontaneous fracture and migration of catheter of a totally implantable venous access port via internal jugular vein - a case report

Park

Hwang

et al. 2016

J Cardiothorac Surg

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BackgroundThe totally implantable venous access ports (TIVAPs) are indicated for patients undergoing chemotherapy, total parenteral nutrition and long-term antibiotic treatment. But, among their complications, the fracture and migration of the catheter of a TIVAP via internal jugular vein represents a very rare but potentially severe condition.Case presentationA 50-year-old woman indentified with a spontaneous fracture and migration of catheter of a TIVAP via right internal jugular vein after adjuvant chemotherapy for ovary cancer. She had been not evaluated and not managed with the heparin lock flush solution during three months after adjuvant chemotherapy. And then, she complained right neck bulging during saline infusion via a TIVAP and a chest radiography showed the fractured and migrated catheter of a TIVAP in right atrium. So, we emergently removed the catheter fragment by a goose neck snare via right femoral vein. After then, there was no problem.ConclusionsIf the fractured catheter of a TIVAP is detected, it is desirable to remove a fragment by an endovascular approach if it is possible.

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Fractures of Totally Implantable Central venous Ports: More than Fortuity. A Three-Year Single Center Experience

Abstract: The actual advantage of using port connected with Groshong silicon catheters should be questioned, since apparently they are more fragile than standard catheters. Furthermore, ultrasound-guided "out-of-plane" puncture of the internal jugular vein should be discouraged.

Cited by 17 publications

References 26 publications

Femoral placement of a totally implantable venous access port with spontaneous catheter fracture: case report

Femoral placement of a totally implantable venous access port with spontaneous catheter fracture: case report

Desconexão de cateter para quimioterapia: uma complicação rara?

Spontaneous fracture and migration of catheter of a totally implantable venous access port via internal jugular vein - a case report

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