Abstract
BackgroundThe totally implantable venous access ports (TIVAPs) are indicated for patients undergoing chemotherapy, total parenteral nutrition and long-term antibiotic treatment. But, among their complications, the fracture and migration of the catheter of a TIVAP via internal jugular vein represents a very rare but potentially severe condition.Case presentationA 50-year-old woman indentified with a spontaneous fracture and migration of catheter of a TIVAP via right internal jugular vein after adjuvant chemotherapy for ovary cancer. She had been not evaluated and not managed with the heparin lock flush solution during three months after adjuvant chemotherapy. And then, she complained right neck bulging during saline infusion via a TIVAP and a chest radiography showed the fractured and migrated catheter of a TIVAP in right atrium. So, we emergently removed the catheter fragment by a goose neck snare via right femoral vein. After then, there was no problem.ConclusionsIf the fractured catheter of a TIVAP is detected, it is desirable to remove a fragment by an endovascular approach if it is possible.
Highlights
The totally implantable venous access ports (TIVAPs) are indicated for patients undergoing chemotherapy, total parenteral nutrition and long-term antibiotic treatment
If the fractured catheter of a TIVAP is detected, it is desirable to remove a fragment by an endovascular approach if it is possible
We report a case indentified with a spontaneous fracture and migration of catheter of a TIVAP via right internal jugular vein (IJV) after adjuvant chemotherapy for ovary cancer and successfully retrieved by percutaneous endovascular approach
Summary
A totally implantable venous access port (TIVAP) plays a crucial role in the treatment of patients in oncology [1]. A spontaneous fracture and migration of a TIVAP via internal jugular vein (IJV) is the more rare. A function of TIVAP was good, and a chest radiography showed the TIVAP located at the optimal position (Fig. 1a). She had been performed a chemotherapy via this TIVAP by a planned schedule. The fractured catheter fragment was subsequently caught and moved into the right femoral vein using a goose neck snare (Cook Inc, Bloomington, IN, USA) (Fig. 2a, b). The fractured catheter fragment was removed successfully with venous sheath (Fig. 2c). After the confirmation of hemostasis on venous puncture site, the remnant port was removed surgically under local anesthesia.
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