Catheter Fragments Embolization

Abstract

Although the use of central venous silicone catheters is widespread, little is known about the incidence of catheter rupture and embolization. Over a three-year period, 3916 silicone catheters were inserted in 3672 patients in the authors' hospital. Catheter or catheter fragments embolism occurred in 4 patients (1.2 embolizations per 1000 patients treated). Inappropriate mechanical deobstruction attempts resulted in 2 embolizations, and hence, these should be avoided. Chest roentgenography failed to detect the small fragments within the heart silhouette in 2 cases. Two-dimensional echocardiography showed the separated catheter fragment in all 4 cases. All four catheter fragments were subsequently removed from the right-heart chambers.

Anatomical basis of central venous catheter fracture

“…The pinch-off sign is observed in immediate postoperative chest X-rays 1.1-5.0% of cases (Di Carlo et al, 2000). In a series of 3,916 silicone catheters placed in patients, catheter fragmentation and embolization occurred in four cases (1.2 embolizations per one thousand patients treated) (Monsuez et al, 1997).…”

“…This sign indicates compression of the catheter as it passes between the clavicle and the first rib. Catheter fracture and embolization are rare, occurring in approximately one per one thousand catheters placed intravenously (Monsuez et al, 1997). However, the many thousands of central venous catheters placed annually in hospitals (Hind et al, 2003) worldwide makes this potential risk significant.…”

Atypical pulmonary embolism of port catheter fragments in oncology patients

“…Catheter fracture and intravasal embolization are rare but, nevertheless, a possible complication. It occurs with an incidence from 0.1 to 4.2% [1,15,18]. The incidence and clinical picture of catheter fragments embolization into the pulmonary arteries are unknown.…”

Der Führungsdrahtverlust bei Seldinger-Technik als Auslöser einer Phlebothrombose

“…Ihre Häufigkeit wurde in einer Untersuchung mit 4 Fällen auf 3.916 in 3 Jahren angelegte Katheter ermittelt [23]. Ihre Häufigkeit wurde in einer Untersuchung mit 4 Fällen auf 3.916 in 3 Jahren angelegte Katheter ermittelt [23].…”