Port-A-Cath Catheter Embolization to Distal Pulmonary Artery Branches: Two Tailored Percutaneous Retrieval Approaches

Vasc Endovascular Surg. 2018 Jul;52(5):361-366. doi: 10.1177/1538574418762191. Epub 2018 Mar 8.

Abstract

Several types of intravascular devices and catheters are frequently used for long-term drug therapy, especially for oncological patients. As a result, complications are becoming increasingly common, namely catheter embolization. Retrieving these devices is important, as embolized fragments may lead to serious consequences, such as arrhythmias, myocardial injury, thrombosis, infection, and even perforation and death. We describe 2 cases of long-term drug catheter (Port-A-Cath) fracture, incidentally documented in a routine chest radiograph. In both cases, percutaneous extraction was attempted, yet the procedure was complicated by embolization of smaller fragments into the arterial pulmonary vasculature. We describe unusual approaches in successfully retrieving the remaining fragments. The ideal approaches for removal of foreign bodies from the cardiovascular system differ from case to case, but percutaneous extraction should be preferred in most of the cases. Less common techniques may be helpful in challenging cases.

Keywords: Port-A-Cath; catheter embolization; percutaneous retrieval; totally implantable port devices.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Administration, Intravenous
  • Antineoplastic Agents / administration & dosage*
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation*
  • Device Removal / methods*
  • Embolism / diagnostic imaging
  • Embolism / etiology
  • Embolism / therapy*
  • Equipment Design
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / etiology
  • Foreign-Body Migration / therapy*
  • Humans
  • Incidental Findings
  • Middle Aged
  • Pulmonary Artery* / diagnostic imaging
  • Treatment Outcome
  • Vascular Access Devices / adverse effects*

Substances

  • Antineoplastic Agents