H Rebahi1, A G El Adib2, Y Mouaffak2, M El Hattaoui3, A Chaara4, H Sadek5, M Khouchani5, L Mahmal5, S Younous2. 1. Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc. Electronic address: r-houssam@hotmail.com. 2. Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc. 3. Service de cardiologie, hôpital Ibn Tofail, CHU Mohammed VI, rue Al Moustachfa, Gueliz 40000, Marrakech, Maroc. 4. Unité de cardiologie interventionnelle, clinique internationale de Marrakech, route de l'Aéroport, Bab Ighli 40000, Marrakech, Maroc. 5. Service d'onco-radiothérapie, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
Abstract
INTRODUCTION: Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries. CASE REPORTS: We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory. CONCLUSION: We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it.
INTRODUCTION: Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries. CASE REPORTS: We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory. CONCLUSION: We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it.