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Case study of central venous catheter fracture

"Two years after the CV port was implanted, a catheter fracture was found on a chest X-ray performed during a regular visit" Uchi et al (2021).

Extract:

This is the case of a 72-year-old man in whom multiple colorectal cancers including rectal and appendiceal cancers and synchronous S3 liver metastases were observed in 2014, and resection was performed in 2 stages. In 2017, a single recurrence was found in the liver S8, and he underwent a liver S8 sub-segmental resection. Implantation of a CV port for postoperative chemotherapy was planned. At the time of insertion, the catheter was punctured from the exterior portion of the left subclavian vein to avoid the pinch-off syndrome wherein the catheter is crushed between the clavicle and the first rib. Subsequently, FOLFOX therapy was started, but it was discontinued because of allergic symptoms, which appeared during the third course. Two years after the CV port was implanted, a catheter fracture was found on a chest X-ray performed during a regular visit. Since the detached catheter did not fall into the vein, it was possible to remove the port under fluoroscopy. When a catheter is implanted, even under ultrasound guidance, it is considered important to always keep in mind the possibility of a catheter fracture and to detect and respond to it early.

Reference:

Uchi R, Kawamoto J, Takagi Y, Matsuyama N, Hirota M, Oda K, Otsuka M. . Gan To Kagaku Ryoho. 2021 Mar;48(3):443-445. Japanese. PMID: 33790182.