[Catheter fracture and pulmonary embolization of the distal fragment: a rare complication of the totally implantable venous access port]

Abstract

Introduction: Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries.

Case reports: We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory.

Conclusion: We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it.

Keywords: Artères pulmonaires; Catheter fracture; Chambre à cathéter implantable; Migration; Pulmonary embolization; Rupture de cathéter; Totally implantable venous access port.