Abstract
Key Clinical MessageTotally implantable venous access ports are valuable invention for oncological patients. Erroneous arterial malposition rate is estimated from 1.1% to 3.7% (Bowen et al. Am. J. Surg., 2014, 208, 937). Early recognition and management are crucial to prevent further complications.
Highlights
Procedure was performed by right internal jugular vein (RIJ) approach under ultrasound and fluoroscopic guidance
A computed tomography (CT) angiogram revealed a rightsided Port-A-Cath perforating RIJ and entering the right subclavian artery (RSA) (Fig. 2) with a tip localized in the aorta (Fig. 3)
Erroneous arterial cannulation may lead to hematoma, pseudoaneurysm, arteriovenous fistula, dissection, hemorrhage, extremity ischemia, embolization, and even death [2]
Summary
Implantable venous access ports are valuable invention for oncological patients. Erroneous arterial malposition rate is estimated from 1.1% to 3.7% Interventional radiology, malpositioned central venous catheter, Port-A-Cath. A 89-year-old female with metastatic Merkel cell carcinoma underwent a central venous port placement (Port-A-Cath) for chemotherapy [1]. Procedure was performed by right internal jugular vein (RIJ) approach under ultrasound and fluoroscopic guidance. The port was tested and found to flush and aspirate appropriately. A computed tomography (CT) angiogram revealed a rightsided Port-A-Cath perforating RIJ and entering the right subclavian artery (RSA) (Fig. 2) with a tip localized in the aorta (Fig. 3). Patient underwent endovascular retrieval of the malposition Port-A-Catheter combined with a stent graft placement into the RSA without complications (Fig. 4)
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