The “pinch-off sign”: A warning of impending problems with permanent subclavian catheters

Aitken, Delmar R.; Minton, John P.

doi:10.1016/0002-9610(84)90340-4

Cited by 205 publications

(103 citation statements)

References 2 publications

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“…In addition, gastric carcinoma entails a higher incidence of thrombotic events. It has been suggested that thrombotic formations on the catheter can also pose an elevated risk of catheterrelated sepsis [30,31]. Our study is not in the position to address this statement, since port systems were observed only until the first appearing complication.…”

mentioning

confidence: 78%

Evaluation of Correlations between Underlying Disease and Port Complications

Teichgräber¹,

Nagel²,

Kausche³

2014

Fortschr Röntgenstr

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Purpose: Evaluation of correlations between underlying disease and port complications. Materials and Methods: Retrospective analysis of a data set of 3160 port systems, which had been interventionally implanted over a period of 10 years. Of these, 1393 were included in the final evaluation. The 7 most common underlying diseases and port-induced complications were considered. Port-related thrombotic events, port pocket infections as well as the port-induced sepsis were evaluated and classified as either early or late complications. Results: In 1393 ports, 131 experienced complications. Of these, 22.1?% (n?=?29) were early and 79.6?% (n?=?102) late complications. The overall incidence rate of late complications was 0.253/1000 observed days. It differed significantly between the underlying diseases (p?

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mentioning

confidence: 78%

Evaluation of Correlations between Underlying Disease and Port Complications

Teichgräber¹,

Nagel²,

Kausche³

2014

Fortschr Röntgenstr

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“…POS with intravenous catheter fracture and migration is rare with a reported incidence of 0.1-1% (1). This syndrome was described by Aitken et al in 1984, and is characterized by intermittent catheter malfunction in conjunction with radiologic evidence of catheter compression between clavicle and first rib (2). A radiological scale of catheter distortion was defined by Hinke et al (3): grade 0, no compression and distortion; grade 1, no luminal catheter narrowing but deviation; grade 2, luminal narrowing as the catheter passes under the clavicle (true pinch-off sign); and grade 3 defines complete catheter transection and embolization of the distal catheter.…”

Section: Discussionmentioning

confidence: 99%

Fracture and atypical migration of an implantable central venous access device

Mery¹,

Palengat²,

Loffroy³

et al. 2016

Quant. Imaging Med. Surg.

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Distal embolization of a fractured indwelling central catheter is a rare complication. The pinchoff syndrome (POS) should be known, prevented and early detected. We present a case in which further radiological exams were required to find the fragmented catheter with an atypical migration, requiring local surgery for removing. After chest and abdominal CT scan, neck X-ray, and heart echography, the catheter was found on the lower limbs X-ray on the internal side of right knee corresponding to a location of saphenous vein. Implanted catheters should be removed after completion of treatment and the integrity of the system should be monitored. To avoid POS, a catheter must be inserted into the subclavian vein as laterally as possible.

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“…1 The aetiology might be associated with the pinching effect of the catheter as it passes between the clavicle and the first rib. 2 Fractures can be minimised by instructing the patient to abstain from heavy physical activities or shoulder movements. 3 Once a fracture has occurred, the fragment should be located and removed as soon as possible to prevent lifethreatening dysrhythmias and other complications.…”

Section: Discussionmentioning

confidence: 99%

Lasso technique for retrieving a broken, dislocated port-a-cath fragment

Bindraban

Klippe²,

Bergen³

et al. 2009

NHJL

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75 IMAGING IN CARDIOLOGYLasso technique for retrieving a broken, dislocated port-a-cath fragment A 52-year-old woman suffering from breast cancer had a port-a-cath implanted to administer chemotherapy. A port-a-cath (a portmanteau of portal and catheter) consists of a reservoir compartment (the portal) which has a silicone bubble for needle insertion (the septum) mounted to the catheter. Six and a half months after implantation, she complained of palpitations. An ECG showed sinus rhythm with premature atrial complexes. An X-ray showed dislocation of the distal tip of the catheter with migration into the right atrium (RA) and right ventricle (RV).To remove the port-a-cath fragment, we performed a right heart catheterisation by inserting an 8 French sheath into the femoral vein. Using the lasso technique, a long standard guide wire (0.018 inch, 260 cm) was advanced through the lumen of the 7 F intervention catheter (MPA-1, Cordis, Vista bright tip, 100 cm, .078 ID), as shown in figure 1. By manipulating and applying traction to both ends of the guide wire and the catheter, we were able to adjust the diameter and direction of the loop to capture and secure the broken, dislocated port-a-cath fragment. This was then drawn up to the tip of the intervention catheter (figure 2) and successfully removed by extracting the intervention catheter outside the sheath. By both collapsing and banding the broken port-a-cath fragment at its midpoint, the sharp barbs at the end of this were directed away from the vein wall, thus minimising injury during

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The “pinch-off sign”: A warning of impending problems with permanent subclavian catheters

Cited by 205 publications

References 2 publications

Evaluation of Correlations between Underlying Disease and Port Complications

Evaluation of Correlations between Underlying Disease and Port Complications

Fracture and atypical migration of an implantable central venous access device

Lasso technique for retrieving a broken, dislocated port-a-cath fragment

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