Open AccessFractura de catéter implantable con reservorio por síndrome de pinch-off
Author(s) -
Mariano Norese,
Clínica Bazterrica. Buenos Aires. Argentina,
Gustavo F. Andersen,
Diego Sinagra
Publication year - 2021
Publication title -
revista argentina de cirugía/revista argentina de cirugía
Language(s) - English
Resource type - Journals
eISSN - 2250-639X
pISSN - 0048-7600
DOI - 10.25132/raac.v113.n2.1539.ei
Subject(s) - medicine , catheter , clavicle , venous access , subclavian vein , surgery , rib cage , complication , radiology , anatomy
Fracture and migration of totally implantable venous access devices is a rare but potentially serious complication. Pinch-off syndrome was described in subclavian venous accesses when the intermittent compression of the catheter between the first rib and the clavicle produces catheter fracture. The report the case of a patient with cancer who underwent implantation of a totally implantable venous access device through the subclavian vein under ultrasound and radioscopy guidance. After several cycles of chemotherapy, the patient started with malfunctioning of the device. The chest X-ray showed a complete fracture of the catheter at the level of the costoclavicular space with migration of a fragment of the catheter to the right cardiac chambers. The fractured catheter was percutaneously removed via the right femoral vein using nitinol gooseneck snare without complications. The incidence of the pinch-off syndrome, risk factors and prevention measures in totally implantable venous access devices are analyzed.