Abstract
Catheter migration is a rare but important complication of the totally implantable venous access device (TIVAD), and is estimated to be in the range of 0.2% to 1.7%. While there are many causes of catheter disruption and migration, the commonest is chronic strain to the catheter due to compression between the clavicle and first rib - the so-called pinch-off syndrome. This compression can cause transitory obstruction of the catheter and may result in a split or even complete transection and migration of the catheter. Catheter migration is a rare but important complication of TIVAD. These disruptions may be asymptomatic but may cause significant consequences such as cardiac arrhythmias and even death. The recognition of the separation of the catheter and port on plain radiographs should lead to early intervention to prevent catheter migration.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ballarini C, Intra M, Pisani Ceretti A et al (1999) Complications of subcutaneous infusion port in the general oncology population. Oncology 56:97–102
Biffi R, de Braud F, Orsi F et al (1998) Totally implantable central venous access ports for longterm chemotherapy, a prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 9:767–773
Lokich JJ, Bothe A Jr, Benotti P, Moore C (1985) Complications and management of implanted venous access catheters. J Clin Oncol 3:710–717
Sattari M, Kazory A, Phillips RA (2003) Fracture and cardiac migration of an implanted venous catheter. Interact Cardiovasc Thorac Surg 2:532–533
Gallieni M, Pittiruti M, Biffi R (2008) Vascular access in oncology patients. Cancer J Clin 58:323–346
Andris DA, Krzywda EA, Schulte W et al (1994) Pinch-off syndrome: a rare etiology for central venous catheter occlusion. JPEN J Parenter Enteral Nutr 18:531–533
Hinke DH, Zandt-Stastny DA, Goodman LR et al (1990) Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology 177:353–356
Koller M, Papa MZ, Zweig A, Ben-Ari G (1998) Spontaneous leak and transection of permanent subclavian catheters. J Surg Oncol 68:166–168
Ouaknine-Orlando B, Desruennes E, Cosset MF et al (1999) The pinch-off syndrome: main cause of catheter embolism. Ann Fr Anesth Reanim 18:949–955
Behrend M, Paboura E, Raab R (2002) Late embolization of an unfractured port catheter into the heart: report of a case. Surg Today 32:724–726
Faraj W, Zaghal A, El-Beyrouthy O, Kutoubi A (2010) Complete catheter disconnection and migration of an implantable venous access device: the disconnected cap sign. Ann Vasc Surg 24:692
Iannelli A, Kianmanesh R, Msika S et al (2001) Post-traumatic fracture and migration in the pulmonary artery of the catheter of a totally implantable venous access device. Unusual complication. Minerva Chir 56:303–306
Burzotta F, Romagnoli E, Trani C (2008) Percutaneous removal of an embolized port catheter: description of a new coaxial recovery technique including a case-report. Catheter Cardiovasc Interv 72:289–293
Elkhoury MI, Boeckx WD, Chahine EG et al (2008) Retrieval of port-a catheter fragment from the main and right pulmonary arteries 3 years after dislodgment. J Vasc Access 9:296–298
Schulmeister L (2010) Management of non-infectious central venous access device complications. Seminars in Oncology Nursing, pp 132–141
Barnacle A, Arthurs OJ, Roebuck D et al (2008) Malfunctioning central venous catheters in children: a diagnostic approach. Pediatr Radiol 38:363–378
Binnebosel M, Grommes J, Junge K et al (2009) Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long term complication: a case report. Cases J 9:7991
Jordan K, Behlendorf T, Surov A et al (2008) Venous access ports: frequency and management of complications in oncology patients. Onkologie 31:404–410
Gowda MR, Gowda RM, Khan IA et al (2004) Positional ventricular tachycardia from a fractured mediport catheter with right ventricular migration—a case report. Angiology 55:557–560
Lam AW, Chen YM, Yang KY et al (1999) Disconnection of a venous port-A-cath followed by embolisation, after saline flush, rare case report. Jpn J Clin Oncol 29:643–645
Surov A, Buerke M, John E et al (2008) Intravenous port catheter embolization: mechanisms, clinical features, and management. Angiology 59:90–97
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag Italia
About this chapter
Cite this chapter
Faraj, W., Zaghal, A. (2012). Catheter Migration. In: Di Carlo, I., Biffi, R. (eds) Totally Implantable Venous Access Devices. Springer, Milano. https://doi.org/10.1007/978-88-470-2373-4_27
Download citation
DOI: https://doi.org/10.1007/978-88-470-2373-4_27
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-2372-7
Online ISBN: 978-88-470-2373-4
eBook Packages: MedicineMedicine (R0)