scholarly journals Fractura de catéter implantable con reservorio por síndrome de pinch-off

2021 ◽  
Vol 113 (2) ◽  
pp. 258-262
Author(s):  
Mariano Norese ◽  
◽  
Gustavo F. Andersen ◽  
Diego L. Sinagra
Keyword(s):  
Femoral Vein ◽  
Venous Access ◽  
Prevention Measures ◽  
Intermittent Compression ◽  
Chest X Ray ◽  
And Migration ◽  
The Right ◽  
Catheter Fracture ◽  
Venous Access Device ◽  
Venous Access Devices

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.

Late fracture of Groshong ports: A report of the three cases

2019 ◽  
Vol 20 (5) ◽  
pp. 563-566 ◽  
Author(s):  
Fumito Saijo ◽  
Mitsuhisa Mutoh ◽  
Joho Tokumine ◽  
Odaka Yoshinobu ◽  
Hikaru Hama ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Access ◽  
Access Device ◽  
Device Implantation ◽  
Catheter Fracture ◽  
Venous Access Device ◽  
Enhanced Computed Tomography ◽  
Venous Access Devices

Background: Totally implantable venous access devices are valuable tools for total parenteral nutrition, chemotherapy, and long-term intravenous therapy. However, late catheter fracture is a well-known complication of totally implantable venous access device, particularly in Groshong silicone catheter. Recently, a specific type of totally implantable venous access device made with Groshong silicone has been introduced to facilitate power injection of contrast medium for enhanced computed tomography. Cases description: We reported three cases of catheter fracture in power-injectable Groshong silicone totally implantable venous access device. From May 2012 to August 2014, 66 patients underwent power-injectable Groshong silicone totally implantable venous access device implantation at our institution, with a median follow-up of 20.1 (range 0.2–58.1) months. The catheters in all patients were inserted into the internal jugular vein under ultrasound guidance and were connected to the port implanted in the upper chest through the subcutaneous tunnel. Chemotherapy was administered using these routes. Fractures of all three cases specifically showed a torn catheter section: smooth surface on one side, and a rough edge on the other side of the catheter, suggesting that long-term repeated stretch force may be related with the mechanism of fracture. Conclusion: Totally implantable venous access devices with Groshong silicone catheters, if inserted via the internal jugular vein, have a potential risk for late catheter fracture.

Rare cause of extravasation from implantable venous access device

2021 ◽  
Vol 14 (2) ◽  
pp. e239103
Author(s):  
Ponmani Agasthiya Manimaran ◽  
Prakash Agarwal ◽  
Madhu Ramasundaram ◽  
Jegadeesh Sundaram
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Jugular Vein ◽  
Venous Access ◽  
Access Device ◽  
X Ray ◽  
Correct Placement ◽  
Intravenous Antibiotics ◽  
The Right ◽  
Venous Access Device ◽  
Venous Access Devices

Implantable venous access devices are routinely used, but they are not without complications. A 4-year-old male child with B cell acute lymphoblastic leukaemia was planned for chemotherapy. Chemo port was accessed through the right internal jugular vein. Check X-ray was done, which showed the correct placement of the catheter. Two months after chemo port insertion when the patient underwent chemotherapy, he developed a fever and he was started on intravenous antibiotics. On the next two admissions, the patient had a fever with chamber site oedema for which culture was done, which revealed Pseudomonas and Candida, which responded to antibiotic and antifungal therapies. In the successive admission, the patient had immediate local oedema on injecting chemotherapy. Exploration was done, which revealed chamber base perforation. It is an infrequent complication and has been reported in only three studies.

scholarly journals Migration of catheter of a totally implantable venous access port to right thoracic cavity in a child - a case report

2021 ◽  
Author(s):  
Qiteng Xu ◽  
Yueyi Ren ◽  
Yifei Hu ◽  
Shuhua Duan ◽  
Rui Chen ◽  
...  
Keyword(s):  
Venous Access ◽  
Thoracic Cavity ◽  
Severe Condition ◽  
Access Port ◽  
Intravenous Antibiotics ◽  
Catheter Tip ◽  
Life Threatening ◽  
Venous Access Port ◽  
And Migration ◽  
The Right

Abstract BackgroundThe totally implantable venous access port (TIVAP) is a secure and practical choice for children undergoing long-term chemotherapy. Nevertheless, various complications still need to be treated cautiously. Among the complications, the migration of catheters to the thoracic cavity is a very rare (but potentially severe) condition that may necessitate device reimplantation. Furthermore, this migration may even be life-threatening if it is not detected in time.Case presentationA 1-year-old girl undergoing palliative chemotherapy underwent TIVAP placement via the right internal jugular vein. During the operating procedure, the catheter tip was located in the right atrium, which was confirmed by the use of C-arm. Prophylactic intravenous antibiotics were then adopted with routine aspiration and with flushing being conducted each time before administration. Massive right pleural effusion and migration of the catheter tip to the right thoracic cavity were detected on the 2nd day after implantation, which resulted in the removal and reimplantation of the TIVAP device.ConclusionsThe migration of the catheter into the thoracic cavity should be considered a possible complication of TIVAP implantation in children. Early detection and reimplantation may provide opportunities for the prevention of further severe complications.

Acute laryngeal paralysis induced by the migration of a totally implantable venous access device’s catheter tip

2004 ◽  
Vol 118 (3) ◽  
pp. 237-239 ◽  
Author(s):  
S. Hervé ◽  
C. Conessa ◽  
J. Desrame ◽  
O. Chollet ◽  
S. Talfer ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Chemotherapeutic Agent ◽  
Jugular Vein ◽  
Venous Access ◽  
Nerve Paralysis ◽  
Laryngeal Paralysis ◽  
Catheter Tip ◽  
The Right ◽  
Venous Access Device ◽  
Carotid Space

The authors report a case of acute vagus nerve paralysis that appeared during a course of chemotherapy. The drugs had been administered through a totally implantable venous access device (TIVAD), whose catheter tip had migrated into the right internal jugular vein (IJV) and was surrounded by a complete venous thrombosis. The supposed aetiology of this paralysis was a leakage of the cytotoxic drug (5-fluorouracil) from the vessel wall into the surrounding carotid space, because of the stagnation of the chemotherapeutic agent above the thrombosis. Four months after cessation of chemotherapy, the laryngeal paralysis was still evident.

Infection of totally implantable venous access devices: A review of the literature

2018 ◽  
Vol 19 (3) ◽  
pp. 230-242 ◽  
Author(s):  
Fulvio Pinelli ◽  
Elena Cecero ◽  
Dario Degl’Innocenti ◽  
Valentina Selmi ◽  
Rosa Giua ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Access ◽  
Outpatient Setting ◽  
Intravenous Therapy ◽  
Access Device ◽  
Venous Access Device ◽  
Treatment Of Infection ◽  
Venous Access Devices

Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient’s quality of life. Nonetheless, totally implantable venous access devices are not free from complications. Among those, infection is the most relevant, affecting patients’ morbidity and mortality—both in the hospital or outpatient setting—and increasing healthcare costs. Knowledge of pathogenesis and risk factors of totally implantable venous access device–related infections is crucial to prevent this condition by adopting proper insertion bundles and maintenance bundles based on the best available evidence. Early diagnosis and prompt treatment of infection are of paramount importance. As a totally implantable venous access device–related infection occurs, device removal or a conservative approach should be chosen in treating this complication. For both prevention and therapy, antimicrobial lock is a major matter of controversy and a promising field for future clinical studies. This article reviews current evidences in terms of epidemiology, pathogenesis and risk factors, diagnosis, prevention, and treatment of totally implantable venous access device–related infections.

scholarly journals A clinical case of adjustment of venous access to a child with Pentalogy of Cantrell

2019 ◽  
Vol 2 (1) ◽  
pp. 56-58
Author(s):  
Andrii Haas
Keyword(s):  
Cardiovascular System ◽  
Blood Vessels ◽  
Congenital Malformation ◽  
Clinical Case ◽  
Femoral Vein ◽  
Venous Catheter ◽  
Venous Access ◽  
Pentalogy Of Cantrell ◽  
The Right

In the presented article, there is a clinical case of difficulties in the production of a venous catheter in a child with congenital malformation of the cardiovascular system (with an abnormal arrangement of blood vessels) There was described the catheterization of the right femoral vein with ultrasound navigation. Possible alternative ways of solving this problem were considered.

Secondary malposition of a PICC-port due to heavy physical exercise: A case report

2021 ◽  
pp. 112972982110394
Author(s):  
Sonia D’Arrigo ◽  
Maria Giuseppina Annetta ◽  
Andrea Musarò ◽  
Mariagrazia Distefano ◽  
Mauro Pittiruti
Keyword(s):  
Physical Exercise ◽  
High Intensity ◽  
Central Venous Access ◽  
Venous Access ◽  
High Intensity Exercise ◽  
Mechanical Complication ◽  
Secondary Migration ◽  
Chest X Ray ◽  
Venous Access Device ◽  
The Impact

Physical exercise is often encouraged in cancer patients, mainly for the purpose of rehabilitation and for its psychological benefit. Some authors also suggest that exercise—specially in patient with peripherally inserted central venous access devices—may contribute to reduce the risk of catheter-related thrombosis. Still, the impact of physical exercise on the risk of device-related complications is not yet defined. We report a case of secondary migration of the tip of an arm port, caused by high-intensity exercise in a woman undergoing chemotherapy because of ovarian cancer. Tip migration was suspected because of malfunction (persistent withdrawal occlusion) and diagnosis established after ultrasound examination and chest x-ray. Even if exercise may yield benefit in the cancer patient on chemotherapy, the risk of mechanical complication of the venous access device—such as tip migration—should be considered in the case of high-intensity exercise.

In defense of the use of peripherally inserted central catheters in pediatric patients

2020 ◽  
pp. 112972982093641
Author(s):  
Alessandro Crocoli ◽  
Simone Cesaro ◽  
Monica Cellini ◽  
Francesca Rossetti ◽  
Luca Sidro ◽  
...  
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Late Complications ◽  
Central Venous ◽  
Central Venous Access Device ◽  
Peripherally Inserted Central Catheters ◽  
Non Invasive ◽  
Venous Access Device ◽  
Central Catheters ◽  
Venous Access Devices

Central venous access devices have revolutioned the care of children affected by malignancies, facilitating management of complex and prolonged infusive therapies, reducing pain and discomfort related to repeated blood samples and indiscriminate venipunctures, thus reducing also psychological stress of both patients and families. In this respect, peripherally inserted central catheters have been disseminated for use, even in pediatric oncology patients, for their many advantages: easy and non-invasive placement with no risk of insertion-related complications, as well as easy removal; reduced need for general anesthesia both for insertion and removal; adequate prolonged performance also for challenging therapies (e.g. stem cell transplantation); and low rate of late complications. Nonetheless, concerns have been recently raised about use of such devices in children with cancer, especially regarding a presumed (but not demonstrated) high risk of catheter-related venous thrombosis. Are we facing a new witch (or peripherally inserted central catheter) hunt? The choice of the central venous access device—particularly in oncologic children—should be based on an evaluation of clinical advantages and risks, as provided by appropriate and scientifically accurate clinical studies.

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