Radiological interventions for correction of central venous port catheter migrations

• Published in: Cardiovascular and interventional radiology 2007-04, Vol.30 (2), p.216-221
• Main Authors: Gebauer, Bernhard, Teichgräber, Ulf Karl, Podrabsky, Petr, Werk, Michael, Hänninen, Enrique Lopez, Felix, Roland
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Brachiocephalic Veins - diagnostic imaging; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - instrumentation; Catheters; Device Removal; Equipment Failure; Female; Foreign-Body Migration - complications; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - therapy; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - therapy; Humans; Jugular Veins - diagnostic imaging; Male; Medical procedures; Middle Aged; Radiography, Interventional - instrumentation; Retrospective Studies; Subclavian Vein - diagnostic imaging
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-006-0218-1

The purpose of the study is to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips. Thirty patients with migrated/malpositioned port catheter tips were included in this retrospective analysis. To visualize the catheter patency, a contrast-enhanced port catheter series was performed, followed by transfemoral port catheter correction with various 5F angiographic catheters (pigtail, Sos Omni), goose-neck snare, or combinations thereof. One patient showed spontaneous reposition of the catheter tip. In 27 of 29 patients (93%), radiological-interventional port catheter correction was successful. In two patients, port catheter malposition correction was not possible because of the inability to catch either the catheter tip or the catheter in its course, possibly due to fibrin sheath formation with attachment of the catheter to the vessel wall. No disconnection or port catheter dysfunction was observed after correction. In migrated catheter tips, radiological-interventional port catheter correction is a minimally invasive alternative to port extraction and reimplantation. In patients with a fibrin sheath and/or thrombosis, port catheter correction is often more challenging.