Korean J Thorac Cardiovasc Surg.  2018 Oct;51(5):333-337. 10.5090/kjtcs.2018.51.5.333.

Pinch-Off Syndrome, a Rare Complication of Totally Implantable Venous Access Device Implantation: A Case Series and Literature Review

• Ilhan BM
• Sormaz IC
• Türkay R

• KMID: 2424749
• DOI: http://doi.org/10.5090/kjtcs.2018.51.5.333

Abstract

BACKGROUND
Pinch-off syndrome (POS) is a rare complication after totally implantable venous access device (TIVAD) implantation. In cancer patients, it is important to prevent this rare complication and to recognize it early if it does occur. We present a case series of POS after TIVAD implantation and the results of a literature search about this complication.
METHODS
From July 2006 to December 2015, 924 permanent implantable central venous catheter implantation procedures were performed. The most common indication was vascular access for chemotherapy.
RESULTS
POS occurred in 5 patients in our clinic. Two patients experienced POS within 2 weeks, and the other 3 patients were admitted to department of surgery, Istanbul Faculty of Medicine at 6 to 14 months following implantation. The catheters were found to be occluded during medication administration, and all patients complained of serious pain. The transected fragments of the catheters had migrated to the heart. They were successfully removed under angiography with a single-loop snare.
CONCLUSION
POS is a serious complication after TIVAD implantation. It is important to be aware of this possibility and to make an early diagnosis in order to prevent complications such as drug extravasation and occlusion events.

Keyword

Totally implantable venous access device; Pinch off syndrome; Catheter fracture

MeSH Terms

Angiography
Catheters
Central Venous Catheters
Drug Therapy
Early Diagnosis
Heart
Humans
SNARE Proteins
SNARE Proteins