Spontaneous migration of subcutaneous central venous catheters.

Along with the increasing use of central venous catheters have come an increasing number of complications. Although many are discovered at the time of insertion, others can occur at a later time. If unrecognized, problems may ensue. We describe two cases of spontaneous migration of subcutaneous venous access catheters to illustrate the importance of early recognition and treatment. In one case, the patient was asymptomatic at the time the migration was discovered, and the catheter was removed. However, in the second case, the patient required hospitalization for sepsis following clot formation around a catheter whose tip was in the internal jugular vein. Migration of a central venous catheter can lead to a number of cardiovascular, neurologic, and infectious complications. Although a number of methods of nonoperative intervention have been used to correct the position of central venous catheters, it is difficult to fix a subcutaneous port, because the entire device is implanted under the skin. Removal and replacement are usually required, especially if the catheter is not in the ideal location after initial placement.