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Catheter fracture: A rare complication of totally implantable subclavian venous access devices

✍ Scribed by Klotz, Hans Peter; Schöpke, Wolfgang; Kohler, Arnold; Pestalozzi, Bernhard; Largiadèr, Felix

Publisher
John Wiley and Sons
Year
1996
Tongue
English
Weight
325 KB
Volume
62
Category
Article
ISSN
0022-4790

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✦ Synopsis

Catheter fracture represents a rare problem among non-infectious complications following the insertion of totally implantable long-term central venous access systems for the application of chemotherapeutic agents. A literature survey revealed a total incidence of catheter fractures of 0-2.1 %. Imminent catheter fracture can be identified radiologically, using different degrees of catheter narrowing between the clavicle and the first rib, called pinch-off sign. Two cases of catheter fracture are described and potential causes are discussed. Recommendations to avoid the pinch-off sign with the subsequent risk of catheter fracture and migration include a more lateral and direct puncture of the subclavian vein. In case of catheter narrowing in the clavicular-first rib angle, patients should be followed carefully by chest X-rays every 4 weeks. Whenever possible, the system should be removed within 6 months following insertion.

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