Intravenous literature: Harrison, E. and Lal, S. (2012) Central venous catheter embolisation. BMJ Case Reports. 2012 Nov 21;2012. pii: bcr2012007249. doi: 10.1136/bcr-2012-007249.
Tunnelled central venous catheters are commonly used for a variety of indications, including home parenteral nutrition, but are rarely associated with fracture and embolisation; the risk of embolisation is reported to be greater with catheters placed via the subclavian vein rather than the internal jugular route. We report the case of a 64-year-old woman with type 3 (chronic and irreversible) intestinal failure who presented with pain and swelling on infusion of parenteral nutrition through her internal jugular catheter. A chest x-ray showed fracture and embolisation of her catheter into the right ventricle. The embolised portion was retrieved and removed via the femoral route, without complication and the catheter replaced. We discuss causes of line embolisation, and highlight the possibility of embolisation occurring with an internal jugular catheter.