Catheter Fracture of a Totally Implantable Venous Device Due to Pinch Off Syndrome in Breast Cancer: A Case Report

Article information

Kosin Med J. 2016;31(2):167-172

Publication date (electronic) : 2016 January 20

doi : https://doi.org/10.7180/kmj.2016.31.2.167

Department of Surgery, Busan Adventist Hospital, Busan, Korea

Corresponding Author: Yoonseok Kim, Department of Surgery, Busan Adventisti Hospital, 170, Daeti-ro, Seo-gu, Busan 49230, Korea Tel: +82-51-600-7707 Fax: +82-51-242-0407 E-mail: mammomaster@naver.com

Received 2015 March 06; 2015 March 06; Accepted 2015 April 08.

Abstract

Totally implantable venous devices are used in medical care for parenteral nutrition, vascular access, administrating chemotherapeutic agents and so on. Although the large variety of catheter complications, catheter fracture is a rare but serious complication. The pinch off syndrome is caused by the compression of the catheter between the clavicle and first rib, and may lead to fracture and possible dislocation of the catheter. We report here the case history of a patient with metastatic breast cancer who developed a rare complication of subclavian catheter fracture as a consequence of pinch off syndrome.

Keywords: Complications; Incidents; Vascular access devices

Fig. 1.

Chest X-ray on admission. This examination showed a complete fracture of catheter.

Fig. 2.

Chest X-ray after port insertion. A close-up of the left clavicle area (circled area) showed a slight compression of the catheter (Hinke's Grade 2).

Fig. 3.

Flouroscopic guided foreign body removal through right femoral vein.

References

1. Hinke DH, Zandt-Stastny DA, Goodman LR, Quebbeman EJ, Krzywda EA, Andris DA. Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology 1990;177:353–6.

2. Osawa H, Hasegawa J, Yamakawa K, Matsunami N, Mikata S, Shimizu J, et al. Ultrasound-guided infraclavicular axillary vein puncture is effective to avoid pinch-off syndrome: a longterm follow-up study. Surg Today 2013;43:745–50.

3. Maisey NR, Sacks N, Johnston SR. Catheter fracture: a rare complication of totally implantable venous devices. Breast 2003;12:287–9.

4. Gowraiah V, Culham G, Chilvers MA, Yang CL. Embolization of a central venous catheter due to pinch-off syndrome. Acta Paediatr 2013;102:e49–50.

5. Fazeny-Dörner B, Wenzel C, Berzlanovich A, Sunder-Plassmann G, Greinix H, Marosi C, et al. Central venous catheter pinch-off and fracture: recognition, prevention and management. Bone Marrow Transplant 2003;31:927–30.

6. Cho JB, Park IY, Sung KY, Baek JM, Lee JH, Lee DS. Pinch-off syndrome. J Korean Surg Soc 2013;85:139–44.

7. Clay TD. Pinch-off syndrome: a simple test is the best. Intern Emerg Med 2012;7:S141–3.

8. Mirza B, Vanek VW, Kupensky DT. Pinch-off syndrome: case report and collective review of the literature. Am Surg 2004;70:635–44.

Article information Continued

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.