Katheterbruch eines implantierbaren zentralvenösen Infusionssystems mit Embolisation in die Arteria pulmonalis

Abstract

A central venous catheter with a subcutaneous infusion port was implanted for chemotherapy into a 64-year-old woman with gastric lymphoma. Six weeks later, two weeks after a trivial trauma with hyperextension of the shoulder joint, it was found that the catheter had broken and its tip portion had embolized into the pulmonary artery: it was retrieved without difficulty via the femoral vein. This event suggests that pressure between clavicle and first rib can cause material fatigue in a silicon catheter. Such catheters should therefore not be implanted via the subclavian vein.

Central venous catheter fracture during pacemaker lead extraction

“…Our preference is to implant the new device in the contralateral pectoral region to minimize the risk of a repeat device infection in the event that the initial local infection is not completely resolved. Axillary as opposed to subclavian venous access is preferred in the insertion of the CVC to avoid the “subclavian crush” syndrome whereby material fatigue due to pressure between the clavicle and first rib may lead to catheter fracture 8, 9. In retrospect, damage to the CVC during the extraction process highlights the importance of careful functional and radiographic evaluation of CVC integrity immediately post extraction.…”

Retained Catheter Fragment from a Fractured Tunneled Catheter-A Rare and Potentially Lethal Complication

“…Sepsis‐related death is 100 times greater in dialysis patients than in the general population, with infection‐related death and all‐cause mortality highest in those with TCCs (5). Approximately 20% of patients dialyzed through a TCC develop osteomyelitis, septic arthritis, and endocarditis and often die, regardless of whether or not the infected catheter is removed (6,7). In addition to infection‐related complications, a several‐fold increase in cardiovascular risk has also been associated with catheter use (5).…”