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Case Reports
. 2023 Feb 22;102(8):e32710.
doi: 10.1097/MD.0000000000032710.

Case report: Extravascular catheter migration in a child: A rare complication of the totally implantable venous access device

Xuning Lu  1 , Yueyi Ren  2 , Hao Wan  2 , Qiteng Xu  2 , Shuhua Duan  2
Affiliations
Case Reports

Case report: Extravascular catheter migration in a child: A rare complication of the totally implantable venous access device

Xuning Lu et al. Medicine (Baltimore). .

Abstract

Background: Totally implantable venous access devices (TIVADs) are widely used to gain intermittent central venous access, such as in patients who need long-term chemotherapy, total parenteral nutrition, and long-term antibiotic treatment. At present, there are many complications associated with the use of these devices. Complete extravascular migration of TIVADs via the internal jugular vein is a very rare and potentially serious condition, especially in children.

Case presentation: A 1-year-old girl needed palliative chemotherapy because of hepatoblastoma complicated by inferior vena cava thrombosis. A TIVAD was implanted through the right internal jugular vein with a routine heparin flushing tube. On the second day after the operation, a pale bloody liquid was drawn out from the device and the chest X-ray was checked to confirm that the position of the catheter was normal. On the third day after the operation, however, the patient's right respiratory sound was weakened on physical examination and auscultation. Fluoroscopy showed that the tip of the catheter was located in the right thoracic cavity, and there was a large amount of effusion in the right thoracic cavity. The pleural effusion was removed, the TIVAD was replaced again, and the child was discharged 2 days later.

Conclusions: Following TIVAD implantation, if abnormalities are found, in addition to chest X-ray, saline flush and echocardiography should be performed to determine the position of the catheter and rule out extravascular migration of the catheter to avoid irreparable consequences.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Intraoperative and postoperative images of the first catheterization. (A) Fluoroscopy shows the tip of the catheter (white arrow) in the right atrium. (B) Chest roentgenogram shows the tip of the catheter (white arrow) in the right atrium.
Figure 2.
Figure 2.
Intraoperative and postoperative images of the second catheterization. (A) Fluoroscopy shows fluid accumulation (black arrows) in the right pleural space with passive atelectasis. The tip of the catheter (white arrow) was in the right pleural space. (B) Fluoroscopy shows the tip of the catheter (white arrow) in the right atrium. (C) Chest roentgenogram shows the tip of the catheter (white arrow) in the right atrium.
See this image and copyright information in PMC

References

    1. Vescia S, Baumgärtner AK, Jacobs VR, et al. . Management of venous port systems in oncology: a review of current evidence. Ann Oncol. 2007;19:9–15. - PubMed
    1. Biffi R, de Braud F, Orsi F, et al. . Totally implantable central venous access ports for long-term chemotherapy. Ann Oncol. 1998;9:767–73. - PubMed
    1. Gebauer B, Teichgräber UK, Podrabsky P, et al. . Radiological interventions for correction of central venous port catheter migrations. Cardiovasc Intervent Radiol. 2007;30:668–74. - PubMed
    1. Narducci F, Jean-Laurent M, Boulanger L, et al. . Totally implantable venous access port systems and risk factors for complications: a one year prospective study in a cancer centre. Eur J Surg Oncol. 2011;37:913–8. - PubMed
    1. Di Carlo I, Pulvirenti E, Mannino M, et al. . Increased use of percutaneous technique for totally implantable venous access devices. is it real progress? A 27-year comprehensive review on early complications. Ann Surg Oncol. 2010;17:1649–56. - PubMed

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