Skip to main content
SpringerLink
Log in

Fracture and migration of implantable venous access port catheters: Cause analysis and management of 4 cases

  • Published:
Journal of Huazhong University of Science and Technology [Medical Sciences] Aims and scope Submit manuscript

Summary

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chernecky C. Satisfaction versus dissatisfaction with venous access devices in outpatient oncology: a pilot study. Oncol Nurs Forum, 2001,2(8):1613–1616

    Google Scholar 

  2. Kurul S, Saip P, Aydin T. Totally implantable venus-access ports: local problems and extravasation injury. Lancet Oncol, 2002,3(11):684–692

    Article  PubMed  Google Scholar 

  3. Babu R, Spicer RD. Implanted vascular access devices (ports) in children, complications and their prevention. Pediatr Surg Int, 2002,18(1):50–53

    Article  CAS  PubMed  Google Scholar 

  4. Maisey NR, Sacks N, Johnston SR. Catheter fracture: a rare complication of totally implantable venous devices. Breast, 2003,12(4):287–289

    Article  CAS  PubMed  Google Scholar 

  5. Cho JB, Park IY, Sung KY, et al. Pinch-off syndrome. J Korean Surg Soc, 2013,85(3):139–144

    Article  PubMed Central  PubMed  Google Scholar 

  6. Nagasawa Y, Shimizu T, Sonoda H, et al. Is catheter rupture rare after totally implantable access port implantation via the right internal jugular vein? Report of a case. Surg Today, 2014,44(7):1346–1349

    Article  PubMed  Google Scholar 

  7. Kao CL, Chang JP. Catheter fracture and embolization from an implanted venous access device. J Emerg Med, 2002,22(1):95–96

    Article  PubMed  Google Scholar 

  8. Lin CH, Wu HS, Chan DC, et al. The mechanisms of failure of totally implantable central venous access system: analysis of 73 cases with fracture of catheter. Eur J Surg Oncol, 2010,36(1):100–103

    Article  CAS  PubMed  Google Scholar 

  9. Wang Q, Xiong B, Zheng C, et al. Percutaneous retrieval of PICC fractures via the femoral vein in six cancer patients. J Vasc Access, 2015,16(1):47–51

    CAS  PubMed  Google Scholar 

  10. Cheng CC, Tsai TN, Yang CC, et al. Percutaneous retrieval of dislodged totally implantable central venous access system in 92 cases: experience in a single hospital. Eur J Radiol, 2009,69(2):346–350

    Article  PubMed  Google Scholar 

  11. Liu JC, Tseng HS, Chen CY, et al. Percutaneous retrieval of 20 centrally dislodged Port-A catheter fragments. Clin Imaging, 2004,28(3):223–229

    Article  PubMed  Google Scholar 

  12. Ku YH, Kuo PH, Tsai YF, et al. Port-A-Cath implantation using percutaneous puncture without guidance. Ann Surg Oncol, 2009,16:729–734

    Google Scholar 

  13. Osawa H, Hasegawa J, Yamakawa K, et al. Ultrasound- guided infraclavicular axillary vein puncture is effective to avoid pinch-off syndrome: a long-term follow- up study. Surg Today, 2013,43(7):745–750

    Article  PubMed  Google Scholar 

  14. Shimizu T, Mekata E, Murata S, et al. A case of catheter fracture of a totally implantable access port introduced through the rightinternal jugular vein. J Surg Oncol, 2011,103(5):460–461

    Article  PubMed  Google Scholar 

  15. Gowda MR, Gowda RM, Khan IA, et al. Positional ventricular tachycardia from fractured mediport catheter with right ventricular migration—a case report. Angiology. 2004,55(5):557–560

    Article  PubMed  Google Scholar 

  16. Kalra VK, Arora P, Lua J. Spontaneous fracture and migration of distal segment of a peripherally inserted central venous catheter to heart in a neonate. J Vasc Access, 2012,13(3):403

    Google Scholar 

  17. Talwar V, Pavithran K, Vaid AK, et al. Spontaneous fracture and pulmonary embolization of a central venous catheter. J Vasc Access, 2003,4(4):158–159

    CAS  PubMed  Google Scholar 

  18. Chow LM, Friedman JN, Macarthur C, et al. Peripherally inserted central catheter (PICC) fracture and embolization in the pediatric population. J Pediatr, 2003,142(2):141–144

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Shu-ping Xiao  (肖书萍), Bin Xiong  (熊 斌), Xiao-fang Li  (李小芳), Qi Yao  (姚 琦) & Chuan-sheng Zheng  (郑传胜)

  2. Department of Surgery, Shanghai Children’s Medical Center, Shanghai Jiaotong University, Shanghai, 200127, China

    Jun Chu  (褚 珺)

Authors
  1. Shu-ping Xiao  (肖书萍)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bin Xiong  (熊 斌)
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jun Chu  (褚 珺)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiao-fang Li  (李小芳)
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qi Yao  (姚 琦)
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chuan-sheng Zheng  (郑传胜)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bin Xiong  (熊 斌).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xiao, Sp., Xiong, B., Chu, J. et al. Fracture and migration of implantable venous access port catheters: Cause analysis and management of 4 cases. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 35, 763–765 (2015). https://doi.org/10.1007/s11596-015-1504-4

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-015-1504-4

Key words

Search

Navigation