Embolization of a fractured central venous catheter placed using the internal jugular approach

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#IVTEAM #Intravenous literature: “Catheter fracture may occur even after placement via the internal jugular approach and may be underestimated because it is often asymptomatic. Interventional radiology techniques using goose-neck and conformational loop snares may be useful to retract an intravascular foreign body.” Shimizu et al.

Reference:

Shimizu, A., Lefor, A., Nakata, M., Mitsuhashi, U., Tanaka, M. and Yasuda, Y. (2014) Embolization of a fractured central venous catheter placed using the internal jugular approach. International Journal of Surgery Case Reports. 5(5), p.219-221.

Abstract:

INTRODUCTION: Fracture and embolization of central venous catheters placed via the subclavian approach is well recognized, but fractured catheters placed via the internal jugular vein are extremely rare.

PRESENTATION OF CASE: A 65-year-old man presented with a catheter embolus after placement of a central venous port using the internal jugular approach undertaken to administer adjuvant chemotherapy for colon cancer with lung metastases. Goose neck and conformational loop snares were successfully used to percutaneously retrieve the severed catheter, which had migrated to the right ventricle.

DISCUSSION: Catheter fracture may occur even after placement via the internal jugular approach and may be underestimated because it is often asymptomatic. Interventional radiology techniques using goose-neck and conformational loop snares may be useful to retract an intravascular foreign body.

CONCLUSION: Imaging studies such as a chest X-ray are mandatory to check that the catheter tip is in the appropriate position during the entire follow-up period even if it was placed through the internal jugular vein.

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