An unusual catheter malposition following totally implantable venous access port insertion: The catheter tip located into the right axillary vein

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.

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

10.21203/rs.3.rs-151065/v1 ◽

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 Background: The 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 presentation: A 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.Conclusions: The 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.

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Characteristics of Symptomatic Axillary Vein Thrombosis After Placement of Totally Implanted Venous Access Port in Cancer Patients

Iranian Journal of Radiology ◽

10.5812/iranjradiol.102754 ◽

2020 ◽

Vol 17 (3) ◽

Author(s):

Myung Gyu Song ◽

Tae-Seok Seo ◽

Woo Jin Yang

Keyword(s):

Lung Cancer ◽

Pancreatic Cancer ◽

Venous Thrombosis ◽

Cancer Patients ◽

Venous Access ◽

Axillary Vein ◽

Access Port ◽

Vein Thrombosis ◽

Axillary Vein Thrombosis ◽

Venous Access Port

Background: The incidence of venous thrombosis based on access route after implantation of the totally implanted venous access port (TIVAP) is controversial. Symptomatic TIVAP-related venous thrombosis remains relatively rare. However, characteristics of symptomatic axillary vein thrombosis after TIVAP implantation via access of the axillary vein has not been reported. Objectives: In this historical cohort study, the incidence and characteristics of venous thrombosis associated with TIVAP via the axillary vein in cancer patients were evaluated. Patients and Methods: A total of 4,773 TIVAPs were placed via the axillary vein in patients with various types of cancer between May 2012 and July 2018. Eighteen patients experienced symptomatic venous thrombosis associated with TIVAPs. Radiologic findings for venous thrombosis were evaluated using computed tomography (CT) including scans of the axillary vein. Medical records were retrospectively reviewed. Results: The prevalence of symptomatic thrombosis was 0.38% (18/4,773). The patients with symptomatic venous thrombosis included 14 males and four females. Among the 18 patients, the most common types of cancer were lung cancer (n = 7) and pancreatic cancer (n = 4), with the incidence rates of 0.79% (lung cancer, 7/882) and 1.58% (pancreatic cancer, 4/253), respectively. The median time between placement of the TIVAP and diagnosis of thrombosis was 35.5 days (range: 6 - 292 days). All symptomatic patients had thrombosis in the axillary vein on CT images. Symptoms were improved in all patients with treatment including removal of TIVAP at the time of diagnosis and following anticoagulation therapy. From the multiple binary logistic regression, pancreatic cancer and lung cancer were statistically significant risk factors of symptomatic axillary vein thrombosis. Conclusion: After insertion of TIVAPs through the axillary vein, symptomatic axillary vein thrombosis rarely developed. Pancreatic cancer and lung cancer were associated with the risk of symptomatic axillary vein thrombosis.

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Calcification and abscess formation around the catheter tip of a central venous access port: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-019-2333-z ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Tomoya Takami ◽

Keisuke Fukuda ◽

Koji Yasuda ◽

Nozomi Kasyu ◽

Hiroyuki Yoshitake ◽

...

Keyword(s):

Case Report ◽

Central Venous Access ◽

Venous Access ◽

Abscess Formation ◽

Central Venous ◽

Access Port ◽

Catheter Tip ◽

Venous Access Port

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P238 Chemotherapy venous access port endocarditis in a patient with breast cancer

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.102 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

A Siama ◽

M Iliopoulou ◽

A Kalogeris ◽

A Tsoukas ◽

A J Manolis

Keyword(s):

Infective Endocarditis ◽

Tricuspid Valve ◽

Venous Access ◽

Left Ventricular ◽

Breast Adenocarcinoma ◽

Access Port ◽

Maximal Diameter ◽

Fungal Endocarditis ◽

Venous Access Port ◽

The Right

Abstract Funding Acknowledgements No funding Background/Introduction Right sided infective endocarditis (IE) accounts for less than 10% of all IE cases. Predisposing factors include portal of entry, implanted foreign material and unrepaired congenital heart disease with conduit. Fungal endocarditis (FE) constitutes the most severe form of IE and is etiologically connected predominantly to Candida and Aspergillus species. Among these two agents, Candida species is a common nosocomial infection with increasing prevalence and mortality rates up to 40% in cases of systemic candidiasis. Individuals with different forms of solid or hematological malignancies, under chemotherapy regimens or bone marrow transplantation comprise a particularly susceptible patient population. Case presentation A 58 year old woman with personal history of triple negative breast adenocarcinoma stage IV under palliative chemotherapy, administered for metastatic mass riknosis in the gastrointestinal tract, was admitted to the Emergency Department of our Hospital due to persistent fever, malaise and dyspnea on effort. Chemotherapy was infused via an implantable venous access port (intraport catheter). Methods/Results: Her heart auscultation revealed a holosystolic ejection type murmur of 3/6 located in the third intercostal space of changing quality. Candida tropicalis was isolated in three separate blood cultures. Transthoracic echocardiography demonstrated a good overall left ventricular systolic function. The right cavities were moderately dilated with moderate tricuspid regurgitation and a pulmonary pressure estimated at 45 mmHg. A large vegetation (approximately 2 cm maximal diameter) at the atrial surface of the posterior and diaphragmatic leaflets of the tricuspid valve with parts of the vegetation periodically apparent in the right ventricle was observed. Transesophageal echocardiography confirmed the findings of the transthoracic study and elucidated in the bicaval view the connection of the vegetation in the tricuspid valve with the edge of the intraport catheter. Moreover computed tomography scan revealed multiple pulmonary emboli in the segmental branches of the bronchial tree and a circumscribed peripheral pulmonary infarct of the left inferior lobe. A multidisciplinary team concluded that the best treatment strategy would require aggressive intravenous combined antifungal therapy until eradication followed by removal of the implantable venous access port, which was uncomplicated. Conclusions The majority of fungal endocarditis episodes represented healthcare-associated infections in vulnerable subsets of patients. Treatment of Candida endocarditis can prove challenging because of the formation of biofilms on prosthetic devices often requiring combination therapy. Septic pulmonary embolism with multiple loci is a frequent complication in right sided infective endocarditis. Removal of the prosthetic device if feasible in addition to antifungal treatment is linked to a more favorable prognosis. Abstract P238 Figure. Chemotherapy intraport endocarditis

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Comparison of comfort and complications in breast cancer patients of implantable venous access port (IVAP) with ultrasound guided internal jugular vein (IJV) and axillary vein/subclavian vein (AxV/SCV) puncture: a randomized controlled study protocol

Annals of Palliative Medicine ◽

10.21037/apm-20-1752 ◽

2020 ◽

Vol 9 (6) ◽

pp. 4323-4331

Author(s):

Yan-Bo Chen ◽

Hao-Shi Bao ◽

He-Ran Deng ◽

Ting-Ting Hu ◽

Biao-Lin Wen ◽

...

Keyword(s):

Breast Cancer ◽

Jugular Vein ◽

Venous Access ◽

Controlled Study ◽

Axillary Vein ◽

Breast Cancer Patients ◽

Ultrasound Guided ◽

Access Port ◽

Randomized Controlled ◽

Venous Access Port

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Modified surface measurement method to determine catheter tip position of totally implantable venous access port through right subclavian vein

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2020.07.004 ◽

2020 ◽

Author(s):

Chenfei Zhou ◽

Li Lu ◽

Liu Yang ◽

Wenqi Xi ◽

Tao Ma ◽

...

Keyword(s):

Subclavian Vein ◽

Measurement Method ◽

Venous Access ◽

Surface Measurement ◽

Access Port ◽

Catheter Tip ◽

Modified Surface ◽

Venous Access Port ◽

Tip Position

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Clinical outcomes of totally implantable venous access port placement via the axillary vein in patients with head and neck malignancy

The Journal of Vascular Access ◽

10.1177/1129729818781270 ◽

2018 ◽

Vol 20 (2) ◽

pp. 134-139 ◽

Cited By ~ 1

Author(s):

Sun Hong ◽

Tae-Seok Seo ◽

Myung Gyu Song ◽

Hae-Young Seol ◽

Sang Il Suh ◽

...

Keyword(s):

Computed Tomography ◽

Head And Neck ◽

Venous Access ◽

Axillary Vein ◽

Head And Neck Malignancy ◽

Access Port ◽

Computed Tomography Images ◽

Neck Malignancy ◽

Venous Access Port ◽

Vein Stenosis

Purpose: To evaluate the clinical outcomes and complications of totally implantable venous access port implantation via the axillary vein in patients with head and neck malignancy. Materials and methods: A total of 176 totally implantable venous access ports were placed via the axillary vein in 171 patients with head and neck malignancy between May 2012 and June 2015. The patients included 133 men and 38 women, and the mean age was 58.8 years (range: 19–84 years). Medical records were retrospectively reviewed. Results: This study included a total of 93,237 totally implantable venous access port catheter-days (median 478 catheter-days, range: 13–1380 catheter-days). Of the 176 implanted totally implantable venous access port, complications developed in nine cases (5.1%), with the overall incidence of 0.097 events/1000 catheter-days. The complications were three central line-associated blood-stream infection cases, one case of keloid scar at the needling access site, and five cases of central vein stenosis or thrombosis on neck computed tomography images. The 133 cases for which neck computed tomography images were available had a total of 59,777 totally implantable venous access port catheter-days (median 399 catheter-days, range: 38–1207 catheter-days). On neck computed tomography evaluation, the incidence of central vein stenosis or thrombosis was 0.083 events/1000 catheter-days. Thrombosis developed in four cases, yielding an incidence of 0.067 events/1000 catheter-days. All four patients presented with thrombus in the axillary or subclavian vein. Stenosis occurred in one case yielding an incidence of 0.017 events/1000 catheter-days. One case was catheter-related brachiocephalic vein stenosis, and the other case was subclavian vein stenosis due to extrinsic compression by tumor progression. Of the nine complication cases, six underwent port removal. Conclusion: These data indicate that totally implantable venous access port implantation via the axillary vein in patients with head and neck malignancy is safe and feasible, with a low axillary vein access-related complication rate.

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