Intravenous Port Catheter Embolization: Mechanisms, Clinical Features, and Management

• Published in: Angiology 2008-02, Vol.59 (1), p.90-97
• Main Authors: Surov, Alexey, Buerke, Michael, John, Endres, Kösling, Sabrina, Spielmann, Rolf-Peter, Behrmann, Curd
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular system; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - instrumentation; Coronary Disease - diagnostic imaging; Coronary Disease - etiology; Coronary Disease - surgery; Device Removal; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Embolism - diagnostic imaging; Embolism - etiology; Embolism - surgery; Equipment Design; Equipment Failure; Female; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - etiology; Foreign-Body Migration - surgery; Heart Atria - diagnostic imaging; Humans; Incidental Findings; Male; Medical sciences; Middle Aged; Miscellaneous; Pharmacology. Drug treatments; Pulmonary Artery - diagnostic imaging; Pulmonary Embolism - diagnostic imaging; Pulmonary Embolism - etiology; Pulmonary Embolism - surgery; Radiography, Interventional; Retrospective Studies; Superior Vena Cava Syndrome - diagnostic imaging; Superior Vena Cava Syndrome - etiology; Superior Vena Cava Syndrome - surgery; Time Factors; Vena Cava, Superior - diagnostic imaging
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319707303883

Venous catheters are important therapeutic devices for the administration of fluid and chemotherapeutic agents; however, their use may be associated with serious complications, such as catheter rupture and embolism. Most data on port catheter embolization consist of isolated case reports; only a few studies have examined a large number of patients with port catheter embolism. The purpose of this study was to identify the incidence of clinical symptoms in patients with catheter dislocation and to determine the role of catheter fragment localization in combination with the presenting symptoms. We conducted a retrospective analysis of patients admitted to Martin-Luther University Hospital Center from January 1994 to September 2005. In total, 41 patients with centrally dislocated catheter fragments were analyzed. Most catheter fragments were located in the pulmonary artery, superior vena cava, and right atrium. Of the patients in whom the catheter fragments were located in the right atrium, right ventricle, and the pulmonary artery, 7.3% presented cardiac symptoms. Catheter malfunction occurred in 39%. In 53.7%, catheter embolism was found incidentally. The embolized catheter fragments were retrieved by a goose-neck snare under fluoroscopy within 24 hours after the diagnosis without any complications. The mean length of these fragments was 11.6 cm. Catheter embolism may go undiagnosed for a prolonged period and be found incidentally. In these patients, predominantly local symptoms occur; however, severe systemic clinical signs may develop. The risk of serious complications in asymptomatic catheter embolism is unknown. Catheter fragments should be removed to prevent further complications.