Catheter Fracture of Intravenous Ports and its Management

Wu, Chia-Huang; Fu, Jui Ying; Feng, Po Hao; Kao, Tsung Chi; Yu, Sheng Yueh; Li, Hao Jui; Ko, Po Jen; Hsieh, Hung Chang

doi:10.1007/s00268-011-1200-x

Cited by 36 publications

(41 citation statements)

References 22 publications

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“…[1] Invasive catheter placement can impose certain risks and clinical management problems. Femoral artery is cannulated by various catheters varying in texture, length and caliber with or without guidewire assistance.…”

Section: Discussionmentioning

confidence: 99%

“…[13] It is commonly reported with subclavian approach and postulated to be preceded by the pinch-off sign. [4] The complication could not be eliminated with internal jugular approach as well.…”

Section: Discussionmentioning

confidence: 99%

“…Majority are asymptomatic. [1] Although there are various signs reported to be classical for a central venous catheter fracture,[136] no such signs are reported for a femoral approach. Ideally catheter material needs to be sufficiently stiff to maintain structural integrity and flexible to minimise discomfort or injury.…”

Section: Discussionmentioning

confidence: 99%

“…[7] Literature review of complications of femoral arterial cannulation found no incidence of catheter fracture, making it a rare complication. [1] A defective catheter escaping quality control checks in the production line might also be a reason for it to fracture under mechanical strain. Relevant to our assumption is a report by Panuccio et al .…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous arterial catheter fracture and embolisation: Unpredicted complication

Kale

Ramalingam

2017

Indian J Anaesth

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Arterial cannulation is a common procedure in the care and management of critically ill patients. Blood pressure measurement, arterial blood sampling and cardiac output determinations are a few primary reasons for arterial cannulation. This invasive catheter placement also imposes certain risks and clinical management problems like bleeding, thrombosis and hematoma formation. Fracture and embolisation of arterial catheters placed in the femoral region is a rare and serious complication that may result in arterial occlusion and thrombosis. Percutaneous retrieval of the foreign body is frequently reported to be the technique of choice, leaving the surgical option to a small group. We report two consecutive cases of catheter fracture that was successfully retrieved by a combination of surgery and balloon tip retrieval device.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spontaneous arterial catheter fracture and embolisation: Unpredicted complication

Kale

Ramalingam

2017

Indian J Anaesth

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“…Long-term stress, neck movement, and compression by backpacks and necklaces are considered potential causes of TIVAP catheter fracture 2. It is reported that placing a TIVAP catheter in the internal jugular vein has fewer complications than placing it in the subclavian vein 3. However, other studies have reported no difference in the frequency of complications between placing a TIVAP catheter in the internal jugular vein and that in the subclavian vein 4.…”

Section: Discussionmentioning

confidence: 99%

Four-dimensional CT-guided transcatheter removal of a fractured migrated catheter of a totally implantable venous access port

Fujimoto

Kasai²,

Sugiura

2017

BMJ Case Reports

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Patients undergoing chemotherapy usually undergo placement of a totally implantable venous access port (TIVAP), but TIVAP catheter fracture is rare. We encountered a case where flushing the TIVAP catheter became impossible because of resistance. A 61-year-old-woman underwent TIVAP placement. Although a chest X-ray revealed the fractured catheter had migrated into the right hilar area, the timing of the fracture was unclear. Four-dimensional computed tomography (4D-CT) showed that the tip of the fractured catheter was located at the anterior segmental artery of the right upper lobe and was immobile, with the remaining portion flapping with the blood flow. Transcatheter removal of the migrated catheter was judged to be possible and was performed successfully. 4D-CT may be useful as an appropriate approach in transcatheter removal of a migrated fractured catheter.

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Initial experiences with a new design for a preattached intravenous port device

et al. 2017

J Biomed Mater Res

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All available conventional ports share a common design, including catheter, locking nut, and port body, and all share two sites of structural weakness. One site is the junction between the locking nut and the proximal end of the catheter. The other site is the catheter fixation site between the locking nut and the protruding stud of the connecting tube. To overcome these shortcomings, we designed a new type of intravenous port which combines the connecting tube into one piece. The aims of this study were to test the mechanical characteristics of the new design and assess its safety in animal study. The prototype of the preattached port was manufactured from biocompatible materials, including PEEK, silicone and polyurethane. All components were assembled with biocompatible glue and mechanical and safety tests were performed to determine the mechanical strength, and tissue reaction of surrounding soft tissue and entry vessels. The mechanical tests showed the new design would not lead to catheter fracture in the oscillation test. The traction test showed significant peak load (18.75 ± 3.29 vs. 26.61 ± 1.75 N; p = 0.036) because of the difference in catheter extension capacity (26.57 ± 4.28 vs. 47.93 ± 2.45 mm; p = 0.012). Significantly smaller endurable injection pressure was identified in the prototype. (90 ± 20 vs. 177.5± 9.48 psi; p = 0.01) The safety test showed good tolerance in beagle dogs and led to no intravascular thrombus and minimal reaction in surrounding tissues. The new prototype preattached port showed good mechanical strength and overcame two potential structural weakness points. The integrated fixation design not only reduced the dimensions of the port device but also provided a greater injection area compared to current designs. It did not cause intravascular thrombosis and produced minimal tissue reaction in surrounding soft tissue, as identified by autopsy. The new design of the fixation device could serve as the basis for the next generation of intravenous ports. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1017-1027, 2018.

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Catheter Fracture of Intravenous Ports and its Management

Cited by 36 publications

References 22 publications

Spontaneous arterial catheter fracture and embolisation: Unpredicted complication

Spontaneous arterial catheter fracture and embolisation: Unpredicted complication

Four-dimensional CT-guided transcatheter removal of a fractured migrated catheter of a totally implantable venous access port

Initial experiences with a new design for a preattached intravenous port device

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