Risk Factors and Possible Mechanisms of Intravenous Port Catheter Migration

The complications of ventriculoperitoneal (VP) shunts are many and are reported in literature extensively. The complication of transanal extrusion after bowel perforation is known although rare. This complication is very well described amongst the children. The authors describe the case of bowel perforation and transanal extrusion of a VP shunt occurring in a 51-year-old adult patient. The patient has a history of craniotomy for acute subdural hematoma after severe head injury one year ago continued with VP shunt for post-traumatic hydrocephalus. Home care with bedridden conditions is done at home until finally, the family gets the catheter extrude from the transanal. Bowel perforation and transanal extrusion of VP shunt catheter is a rare but serious problem. The exact pathogenesis of shunt-related organ perforation and extrusion through the anus is unclear, and various mechanisms have been suggested, Among many factors, age is the prominent factor for bowel perforation.1 Because of weak bowel musculature and stronger peristaltic activity, children are more susceptible to bowel perforation than adult patients. In adult shunted patient, one of the risk factors is related to PVS with chronic immobilization, as described in this case. Risk factors of bowel perforation in adult are quite distinct from children. Persistent vegetative state (PVS) with chronic immobilization is one of the risk factors to be aware of.

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Risk factors associated with distal catheter migration following ventriculoperitoneal shunt placement

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2015.07.022 ◽

2016 ◽

Vol 25 ◽

pp. 46-49 ◽

Cited By ~ 8

Author(s):

Kingsley O. Abode-Iyamah ◽

Ryan Khanna ◽

Zachary D. Rasmussen ◽

Oliver Flouty ◽

Nader S. Dahdaleh ◽

...

Keyword(s):

Risk Factors ◽

Ventriculoperitoneal Shunt ◽

Distal Catheter ◽

Catheter Migration ◽

Factors Associated ◽

Shunt Placement

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Peripherally inserted central cathether migration in neonates: Incidence, timing and risk factors

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200684 ◽

2021 ◽

pp. 1-7

Author(s):

C. Acun ◽

A. Baker ◽

L.S. Brown ◽

K.A. Iglesia ◽

J. Sisman

Keyword(s):

Risk Factors ◽

Neonatal Intensive Care ◽

Venous Catheter ◽

Optimal Frequency ◽

Central Venous ◽

Proper Position ◽

Catheter Migration ◽

Tip Position ◽

Dressing Change ◽

Serial Evaluation

BACKGROUND: PICC line use is a common practice in neonatal units, but it is associated with various complications. Catheter migration is the most common complication in neonates. Periodic imaging is recommended to monitor the tip position of the PICCs, but the optimal frequency is undetermined. The incidence, timing and risk factors that are associated with PICC migration have not been fully investigated beyond 24 hrs in neonates. The aim of the study was to determine the incidence, timing and risk factors that are associated with peripherally inserted central venous catheter (PICC) migration in neonates. METHODS: This was a single center, retrospective study of 168 PICCs placed in 141 neonates in the neonatal intensive care unit (NICU) between 2015 and 2016. The incidence of catheter migration was determined radiographically at 12–24 hrs and every third day after insertion until it was removed. RESULTS: Overall incidence of PICC migration was 28%and most commonly was detected within the first three days after PICC placement (83%). The incidence of PICC migration was higher in males. The PICC migration was associated with difficulty advancing the PICC at the time of insertion and PICC dressing change. CONCLUSION: Serial evaluation of PICC placement in neonates is required to maintain proper position. Based on our experience in our unit, we recommend periodic imaging at 12–24 hrs and on the third day after PICC placement as most migration occurred within three days after insertion.

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Case Report: Ventriculoperitoneal Shunt Catheter Migration and Transanal Extrusion in Persistent Vegetative State Adult Patient

Folia Medica Indonesiana ◽

10.20473/fmi.v55i4.24515 ◽

2021 ◽

Vol 55 (4) ◽

pp. 322

Author(s):

Asra Al Fauzi ◽

Muhammad Arifin Parenrengi ◽

Joni Wahyuhadi ◽

Eko Agus Subagio ◽

Agus Turchan

Keyword(s):

Risk Factors ◽

Adult Patient ◽

Bowel Perforation ◽

Vegetative State ◽

Persistent Vegetative State ◽

Acute Subdural Hematoma ◽

Vp Shunt ◽

Catheter Migration ◽

Shunt Catheter ◽

Old Adult

The complications of ventriculoperitoneal (VP) shunts are many and are reported in literature extensively. The complication of transanal extrusion after bowel perforation is known although rare. This complication is very well described amongst the children. The authors describe the case of bowel perforation and transanal extrusion of a VP shunt occurring in a 51-year-old adult patient. The patient has a history of craniotomy for acute subdural hematoma after severe head injury one year ago continued with VP shunt for post-traumatic hydrocephalus. Home care with bedridden conditions is done at home until finally, the family gets the catheter extrude from the transanal. Bowel perforation and transanal extrusion of VP shunt catheter is a rare but serious problem. The exact pathogenesis of shunt-related organ perforation and extrusion through the anus is unclear, and various mechanisms have been suggested, Among many factors, age is the prominent factor for bowel perforation.1 Because of weak bowel musculature and stronger peristaltic activity, children are more susceptible to bowel perforation than adult patients. In adult shunted patient, one of the risk factors is related to PVS with chronic immobilization, as described in this case. Risk factors of bowel perforation in adult are quite distinct from children. Persistent vegetative state (PVS) with chronic immobilization is one of the risk factors to be aware of.

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Risk Factors and Management of Catheter Malfunction During Urgent-Start Peritoneal Dialysis

Frontiers in Medicine ◽

10.3389/fmed.2021.741312 ◽

2021 ◽

Vol 8 ◽

Author(s):

Lijuan Zhao ◽

Jun Yang ◽

Ming Bai ◽

Fanfan Dong ◽

Shiren Sun ◽

...

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Survival Time ◽

Serum Potassium ◽

Control Group ◽

Catheter Survival ◽

Catheter Migration ◽

Omental Wrapping ◽

Catheter Malfunction ◽

Subcutaneous Tunnel

Background: Catheter malfunction is a common complication of peritoneal dialysis (PD). This study aimed to retrospectively analyze the risk factors and management of catheter malfunction in urgent-start PD.Methods: Patients who underwent urgent-start PD were divided into catheter-malfunction and control groups. Baseline demographic and laboratory data of the two groups were compared, and the risk factors for catheter malfunction were analyzed. Primary outcome measure was catheter survival, and the secondary outcomes were surgical complications and malfunction treatment.Results: Total of 700 patients was analyzed, among whom 143 (20.4%) experienced catheter malfunctions, specifically catheter migration (96, 67.1%), omental wrapping (36, 25.2%), and migration plus omental wrapping (11, 7.7%). Catheter survival time in the malfunction group (202.5 ± 479.4 days) was significantly shorter than that in the control group (1295.3 ± 637.0 days) (P < 0.001). Multivariate analysis revealed higher body mass index [hazard ratio (HR), 1.061; 95% confidence intervals (CI), 1.010–1.115; P = 0.018], lower surgeon count (HR, 1.083; 95% CI, 1.032–1.136; P = 0.001), and higher serum potassium (HR, 1.231; 95% CI, 1.041–1.494; P = 0.036) as independent risk factors for catheter malfunction, while older age (HR, 0.976, 95% CI, 0.962–0.991; P = 0.002) and colonic dialysis (HR, 0.384; 95% CI, 0.254–0.581; P < 0.001) as protective factors. Further subgroup analysis revealed a shorter catheter survival time in patients with younger age ( ≤ 40 years), higher serum potassium levels (≥5 mmol/L), while a longer catheter survival time in patients with colonic dialysis. PD tube and subcutaneous tunnel preservation was successful in 41 out of 44 patients with omental wrapping. All patients had good post-incision prognoses.Conclusions: Urgent-start PD is safe and effective for unplanned PD patients. Adequate pre-operative colonic dialysis and serum potassium level control are conducive in preventing catheter malfunction. Conservative treatment is effective in managing catheter migration alone, while preservation of the PD tube and the subcutaneous tunnel is effective for omental wrapping.

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Analysis of risk factors for implantable venous access port catheter fracture with internal jugular vein

Annals of Palliative Medicine ◽

10.21037/apm.2019.12.04 ◽

2020 ◽

Vol 9 (1) ◽

pp. 30-36 ◽

Cited By ~ 1

Author(s):

Ning Ai ◽

Li Li ◽

Fenghua Yin ◽

Zhigang Li ◽

Cuizhi Geng ◽

...

Keyword(s):

Risk Factors ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous Access ◽

Port Catheter ◽

Access Port ◽

Venous Access Port ◽

Catheter Fracture

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Percutaneous Implantation of a Microcatheter-Port System for Hepatic Arterial Infusion Chemotherapy of Unresectable Liver Tumors: Technical Feasibility, Functionality, and Complications

Diagnostics ◽

10.3390/diagnostics11030399 ◽

2021 ◽

Vol 11 (3) ◽

pp. 399

Author(s):

Olivier Chevallier ◽

Ségolène Mvouama ◽

Julie Pellegrinelli ◽

Kévin Guillen ◽

Sylvain Manfredi ◽

...

Keyword(s):

Hepatic Artery ◽

Liver Tumors ◽

Hepatic Arterial Infusion ◽

Catheter Placement ◽

Port Catheter ◽

Liver Malignancies ◽

Arterial Infusion ◽

Side Hole ◽

Catheter Migration ◽

Catheter Implantation

To evaluate the feasibility and safety of percutaneously implanted arterial port catheter systems for hepatic arterial infusion of chemotherapy (HAI) in patients with unresectable liver malignancies. From October 2010 to August 2018, arterial port catheters for HAI were percutaneously implanted in 43 patients with unresectable liver malignancies. Three different catheter placement techniques were compared: a conventional end-hole catheter placed in the common hepatic artery (technique 1, n = 16), a side-hole catheter with the tip fixed in the gastroduodenal artery (technique 2, n = 18), and a long-tapered side-hole catheter with the tip inserted distally in a segmental hepatic artery (technique 3, n = 6). Catheter implantation was successful in 40 (93%) of the 43 patients. Complications related to catheter placement were observed in 10 (23%) patients; 5 (83%) of the 6 major complications were resolved, as well as all 4 minor complications. Catheter migration and occlusion occurred in 9 (22.5%) patients. Catheter migration was more frequent with technique 1 (n = 6) than with technique 2 (n = 1), although the difference was not significant (p = 0.066). Percutaneous arterial port catheter implantation for HAI is highly feasible and carries a low risk of complications.

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Embolization to great saphenous vein; a rare complication of port catheter migration

The Journal of Vascular Access ◽

10.1177/1129729821989891 ◽

2021 ◽

pp. 112972982198989

Author(s):

Ruth Fuente ◽

Mónica Herrero ◽

Natalia Moradillo ◽

Ignacio Agúndez

Keyword(s):

Saphenous Vein ◽

Great Saphenous Vein ◽

Rare Complication ◽

Port Catheter ◽

Catheter Migration

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An evaluation of the long-term complications associated with totally implantable venous access in oncology patients

Turkish Journal of Vascular Surgery ◽

10.9739/tjvs.2021.860 ◽

2021 ◽

Vol 30 (2) ◽

pp. 127-132

Author(s):

Ahmet Acıpayam ◽

Erdinç Eroğlu

Keyword(s):

Pulmonary Artery ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Catheter Insertion ◽

Port Catheter ◽

Catheter Migration ◽

Us Guidance ◽

The Right ◽

Port Catheters

Objectives: The aim of this study was to examine long-term complications developing in venous port catheters inserted in oncological patients. Patients and methods: A total of 205 oncology patients (124 males, 81 females; mean age: 50.1±22.3 years; range, 6 months to 90 years) in whom vascular port catheters were inserted between March 2015 and April 2020 were retrospectively analyzed. The first preference for port catheter application was the right internal jugular vein. If failed, the contralateral internal jugular vein was used. The procedure was carried out in the operating room with ultrasound (US) guidance under general anesthesia. All patients were evaluated in terms of pneumothorax, catheter orientation, and kinking and malposition after the procedure. Results: A total 219 vascular ports were inserted in 205 patients. The indication for port catheter insertion was the receipt of long-term chemotherapy. Catheters were changed in four patients due to infection and in five patients due to catheter migration. The sites of catheter migration were the right atrium in two, the right ventricle in one, the main pulmonary artery in one, and the right pulmonary artery in one patient. Conclusion: Port catheter insertion under US guidance is a well-designed procedure which can be performed with low complication rates by an experienced surgeon in an aseptic environment. Even if complications develop, they can be usually successfully treated in most cases.

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