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

Affiliations
  • 1Department of Radiology, Korea University Guro Hospital, Seoul, Korea. g1q1papa@korea.ac.kr

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.


Reference

1. Wu PY, Yeh YC, Huang CH, Lau HP, Yeh HM. Spontaneous migration of a Port-a-Cath catheter into ipsilateral jugular vein in two patients with severe cough. Ann Vasc Surg. 2005. 19:734–736.
2. Ballarini C, Intra M, Pisani Ceretti A, Cordovana A, Pagani M, Farina G, et al. Complications of subcutaneous infusion port in the general oncology population. Oncology. 1999. 56:97–102.
3. Rasuli P, Hammond DI, Peterkin IR. Spontaneous intrajugular migration of long-term central venous access catheters. Radiology. 1992. 182:822–824.
4. Roblin D, Porter JC, Knight RK. Spontaneous migration of totally implanted venous catheter systems from subclavian into jugular veins. Thorax. 1994. 49:281–282.
5. DiGiacomo JC, Tarlian HS. Spontaneous migration of long-term indwelling venous catheters. JPEN J Parenter Enteral Nutr. 1991. 15:574–577.
6. Lois JF, Gomes AS, Pusey E. Nonsurgical repositioning of central venous catheters. Radiology. 1987. 165:329–333.
7. Hartnell GG, Gates J, Suojanen JN, Clouse ME. Transfemoral repositioning of malpositioned central venous catheters. Cardiovasc Intervent Radiol. 1996. 19:329–331.
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