Case Report
유방암 환자에서 발생한 중심정맥포트 골절 및 색전증 1예
Spontaneous Fracture and Embolization of Implantable Venous Access Device in Breast Cancer Patient
Korean J Vasc Endovasc Surg 2013; 29(1): 28-31
Published February 28, 2013 https://doi.org/10.5758/kjves.2013.29.1.28
Copyright © The Korean Society for Vascular Surgery.
Abstract
Totally implantable venous access devices (chemoports) are used increasingly in oncology patients to provide simple and durable access for intravenous delivery of drugs and fluids. However, these catheters are associated with a number of complications, such as infection, thrombosis, and stenosis. Fracture of a venous catheter is also a rare complication, known as "pinch-off syndrome." A 43-year-old female with breast cancer was presented with chest pain of one week's duration after undergoing placement of a chemoport for adjuvant chemotherapy. Her chest X-ray showed that a portion of the catheter had broken free and was lodged in the right ventricle. The embolic fragment was successfully retrieved via percutaneous femoral vein insertion of a snare.
Keywords
Breast neoplasms, Catheters, Fracture
References
- Biffi R, de Braud F, Orsi F, Pozzi S, Mauri S, Goldhirsch A, et al. Totally implantable central venous access ports for long-term chemotherapy: a prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 1998;9:767-773.
- Aitken DR, Minton JP. The “pinch-off sign”: a warning of impending problems with permanent subclavian catheters. Am J Surg 1984;148:633-636.
- Ingle RJ. Rare complications of vascular access devices. Semin Oncol Nurs 1995;11:184-193.
- Mirza B, Vanek VW, Kupensky DT. Pinch-off syndrome: case report and collective review of the literature. Am Surg 2004;70:635-644.
- Hinke DH, Zandt-Stastny DA, Goodman LR, Quebbeman EJ, Krzywda EA, Andris DA. Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology 1990;177:353-356.
- Klotz HP, Schopke W, Kohler A, Pestalozzi B, Largiader F. Catheter fracture: a rare complication of totally implantable subclavian venous access devices. J Surg Oncol 1996;62:222-225.
- Yildizeli B, Lacin T, Baltacioglu F, Batirel HF, Yuksel M. Approach to fragmented central venous catheters. Vascular 2005;13:120-123.
- Coles CE, Whitear WP, Le Vay JH. Spontaneous fracture and embolization of a central venous catheter: prevention and early detection. Clin Oncol (R Coll Radiol) 1998;10:412-414.
- Monsuez JJ, Douard MC, Martin-Bouyer Y. Catheter fragments embolization. Angiology 1997;48:117-120.
- Liu JC, Tseng HS, Chen CY, Chern MS, Chang CY. Percutaneous retrieval of 20 centrally dislodged Port-A catheter fragments. Clin Imaging 2004;28:223-229.