Abstract No. 203 Association between chest port catheter tip location at the time of placement and catheter migration resulting in port malfunction

A 53-year-old female with a history of metastatic left arm melanoma presented for F(18) fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) which showed a moderately FDG avid focus at her port catheter tip near the cavoatrial junction. Although catheter tip related FDG avidity has previously been suggested to be bland thrombus or infection, melanoma can metastasize to unusual locations including the superior vena cava. In addition, the patient had an elevated risk of anticoagulation due to a history of hemorrhagic brain metastases. Therefore, confirmatory cardiac magnetic resonance (CMR) was obtained and findings were consistent with bland catheter-related thrombus.

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Advanced stage breast cancer is associated with catheter-tip thrombus formation following implantable central venous port placement

Phlebology The Journal of Venous Disease ◽

10.1177/0268355518774442 ◽

2018 ◽

Vol 34 (2) ◽

pp. 107-114 ◽

Cited By ~ 2

Author(s):

Mina S Makary ◽

Alexander Lionberg ◽

Mamdouh Khayat ◽

Maryam B Lustberg ◽

Jamal AlTaani ◽

...

Keyword(s):

Breast Cancer ◽

Thrombus Formation ◽

Large Population ◽

Advanced Stage ◽

Central Venous ◽

Port Placement ◽

Chest Port ◽

Significant Difference ◽

Catheter Tip ◽

Tip Position

Purpose Catheter-tip associated thrombosis is not uncommon in patients with implantable central venous ports; however, the prevalence and clinical impact of this complication on patient management is unclear. This study aims to identify risk factors for thrombus formation in a large population receiving serial echocardiograms (echo) following port placement. Methods A total of 396 female breast cancer patients underwent internal jugular vein chest port placement between 2007 and 2013 and received echo studies every third month. Catheter tip position was measured from chest radiography and catheter associated thrombus was identified by echo. Results Sixteen out of 396 patients (4%) had catheter-tip thrombus. No patients were symptomatic or prophylactically anticoagulated. Patients with thrombus were significantly younger than those without (46.4 years versus 53.4 years, respectively, p = 0.02) and had higher stage breast cancer with 75% versus 44.7% having stage III or IV cancer ( p = 0.017). Thrombus was identified after a median of 91 days. No significant difference was identified in anatomic ( p = 0.1) or measured ( p = 0.15) tip position, port laterality ( p = 0.86), or number of port lumens ( p = 0.65). Conclusions In this large cohort, younger patients and those with more advanced stage breast cancer were more associated with catheter-tip-related thrombus after port placement.

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Usingn-Butyl Cyanoacrylate and the Fixed-Catheter-Tip Technique in Percutaneous Implantation of a Port-Catheter System in Patients Undergoing Repeated Hepatic Arterial Chemotherapy

American Journal of Roentgenology ◽

10.2214/ajr.179.6.1791611 ◽

2002 ◽

Vol 179 (6) ◽

pp. 1611-1617 ◽

Cited By ~ 42

Author(s):

Takuji Yamagami ◽

Shigeharu Iida ◽

Takeharu Kato ◽

Osamu Tanaka ◽

Tatsuya Hirota ◽

...

Keyword(s):

Port Catheter ◽

Catheter System ◽

Hepatic Arterial Chemotherapy ◽

Catheter Tip

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Management of End Hole in Placement of Port-Catheter System for Continuous Hepatic Arterial Infusion Chemotherapy Using the Fixed Catheter Tip Method

American Journal of Roentgenology ◽

10.2214/ajr.184.4.01841332 ◽

2005 ◽

Vol 184 (4) ◽

pp. 1332-1339 ◽

Cited By ~ 16

Author(s):

Takuji Yamagami ◽

Takeharu Kato ◽

Shigeharu Iida ◽

Tatsuya Hirota ◽

Tsunehiko Nishimura

Keyword(s):

Hepatic Arterial Infusion ◽

Hepatic Arterial Infusion Chemotherapy ◽

Port Catheter ◽

Arterial Infusion ◽

Arterial Infusion Chemotherapy ◽

Infusion Chemotherapy ◽

Catheter System ◽

Catheter Tip

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Minimally Invasive Repair of Azygos Catheter Migration

10.1093/med/9780199986071.003.0041 ◽

2018 ◽

Author(s):

Mikin V. Patel ◽

Steven Zangan

Keyword(s):

Minimally Invasive ◽

Surgical Intervention ◽

Azygos Vein ◽

Central Venous Catheters ◽

Central Venous ◽

Catheter Migration ◽

Catheter Malfunction ◽

Catheter Tip ◽

Catheter Malposition ◽

Multiple Conditions

Central venous catheters are frequently placed to facilitate the care of patients with multiple conditions, often via jugular approach. Occasionally, the catheter tip can migrate after placement and become positioned within the azygos arch. This abnormal catheter positioning can lead to an increased number of complications, including catheter malfunction, thrombosis, or even rupture of the azygos vein requiring surgical intervention. Although invasive repositioning of the catheter is always an option, minimally invasive options can be attempted to repair azygos catheter malposition. Fortunately, noninvasive maneuvers, including manipulation of the port on the skin and patient breathing instructions, can sometimes repair the malpositioned catheter.

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