Removal of "ruptured" pulmonary artery infusion port catheter by pigtail catheter combined with gooseneck trap: A case report

Abstract

BACKGROUND Implanted intravenous infusion port (IVAP) is indicated for patients undergoing chemotherapy, total parenteral nutrition and long-term antibiotic treatment. Among their complications, the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition. CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer. A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery. Therefore, we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap. CONCLUSION When the fractured catheter of an IVAP was detected, the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.

Endovascular Retrieval of a Detached and Dislocated in the Right Heart Chambers' Venous Port Catheter via a Triple-Loop Snare Device

“…Regular chest radiography is recommended to determine the proper position of the catheter and any complications that may arise [ 2 ]. Digital subtraction angiography with contrast medium injection is the gold standard for diagnosing port-a-catheter complications [ 6 ]. It has a high diagnostic performance and allows for potential intervention through an endovascular approach.…”

“…It has a high diagnostic performance and allows for potential intervention through an endovascular approach. Computed tomography angiography may be an alternative, but it is a time-consuming procedure without the opportunity for potential intervention [ 6 ].…”

“…Fragmented catheter positioning can vary and may be located in the hepatic vein, brachiocephalic vein, superior vena cava, pulmonary artery, right atrium, right ventricle, or inferior vena cava [ 5 , 6 , 8 , 11 ]. The most common dislodgment sites are the right atrium, pulmonary artery, superior vena cava, and right ventricle [ 11 ].…”

“…Fracture and migration of a port catheter is a rare complication that can occur after long-term access to the central venous system. If this occurs, the device may migrate and become dislodged in the superior vena cava, right atrium and ventricle, inferior vena cava, or pulmonary artery [ 5 , 6 ].…”

Double pigtail catheter reduction for seriously displaced intravenous infusion port catheter: A case report

“…We used the modified Seldinger puncture to puncture the right femoral vein, and 5F vascular sheath was successfully implanted. Using a long exchange guide wire, we guided the 5F pigtail catheter (Yixinda SCW-StraightPigtail-05110) to the right jugular vein, through the natural bending at the front end of the catheter, trapped the middle and long section of the infusion port catheter, and reset the infusion port catheter by slightly rotating and pulling down[ 5 , 6 ]. Due to the severe displacement of the infusion tube, we failed to reset the catheter using one pigtail.…”