Two Cases of Fractured and Embolized Implanted Central Venous Chemoports in Lung Cancer.

Ju, Jin Yung; Cho, Jae Yeong; Lim, Jung Hwan; Cho, Gye Jung; Chae, Dong Ryeol; Oh, In Jae; Kim, Kyu Sik; Kim, Yu Il; Lim, Sung Chul; Kim, Young Chul; Song, Sang Yoon; Na, Kook Ju; Kim, Yun Hyun; Kim, Jae Kyu

doi:2007.63.5.449

Tuberc Respir Dis > Volume 63(5); 2007 > Article

Case Report

Tuberculosis and Respiratory Diseases 2007;63(5):449-453.
DOI: https://doi.org/10.4046/trd.2007.63.5.449 Published online November 1, 2007.

Two Cases of Fractured and Embolized Implanted Central Venous Chemoports in Lung Cancer.

Jin Yung Ju, Jae Yeong Cho, Jung Hwan Lim, Gye Jung Cho, Dong Ryeol Chae, In Jae Oh, Kyu Sik Kim, Yu Il Kim, Sung Chul Lim, Young Chul Kim, Sang Yoon Song, Kook Ju Na, Yun Hyun Kim, Jae Kyu Kim

¹Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Hwasun, Korea. droij@chonnam.ac.kr
²Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
³Department of Thoracic & Cardiovascular Surgery, Chonnam National University Medical School, Gwangju, Korea.
⁴Department of Diagnostic Radiology, Chonnam National University Medical School, Gwangju, Korea.

Abstract

Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter.

Key Words: Chemoport, Pinch-off syndrome, Pinch-off sign