Korean J Radiol.  2008 Jul;9(Suppl):S81-S84. 10.3348/kjr.2008.9.s.s81.

Spontaneously Migrated Tip of an Implantable Port Catheter into the Axillary Vein in a Patient with Severe Cough and the Subsequent Intervention to Reposition It

• Ahn KS
• Yoo K
• Cha IH
• Seo TS

• KMID: 1100112
• DOI: http://doi.org/10.3348/kjr.2008.9.s.s81

Abstract

Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring.

Keyword

Catheters and catheterization, complications; Veins, interventional procedure; Chemoport

MeSH Terms

Axillary Vein
Catheters, Indwelling/*adverse effects
Cough/*complications
Device Removal/*methods
Foreign-Body Migration/*etiology/radiography
Heart Atria
Humans
Lung Neoplasms/drug therapy
Male
Middle Aged

Figure

• 

  Fig. 1 Migration of implantable port catheter in 64-year-old man. A. Implantable port catheter is inserted via jugular approach. Tip of catheter is well-placed in right atrium. B. Four days after implantation procedure, chest PA radiograph shows coiled catheter and migration of tip from right atrium to right axillary vein. Associated pulmonary edema, cardiomegaly, air space consolidation with volume loss in left lung and pleural thickening with effusion in left hemithorax are also noted. C. 5-Fr pigtail catheter is advanced to right subclavian vein to hook migrated port catheter. D. Gooseneck snare wire and cobra catheter were used to capture wire. E, F. After repositioning (E), catheter shows normal position and curve. However, when we induced patient to cough (F), bending of catheter toward subclavian vein (arrow) was found on fluoroscopy. G. Two days later, recurrent catheter migration was found on chest radiograph. Coiling is noted in middle of catheter, but catheter tip is still located in superior vena cava.

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