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Catheter fracture is a rare complication of totally implantable subclavian venous access devices, with a literature incidence of 0-2.1%, and can be preceded by the radiological pinch-off sign.
Case Report (n=2)
Catheter fracture is a rare complication of subclavian venous access devices that can be anticipated by radiologic identification of the pinch-off sign.
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Alerts clinicians to radiographic pinch-off monitoring in subclavian ports; case reports leave open prospective incidence and prevention studies.
Catheter fracture represents a rare problem among non-infectious complications following the insertion of totally implantable long-term central venous access systems for the application of chemotherapeutic agents. A literature survey revealed a total incidence of catheter fractures of 0-2.1%. Imminent catheter fracture can be identified radiologically, using different degrees of catheter narrowing between the clavicle and the first rib, called pinch-off sign. Two cases of catheter fracture are described and potential causes are discussed. Recommendations to avoid the pinch-off sign with the subsequent risk of catheter fracture and migration include a more lateral and direct puncture of the subclavian vein. In case of catheter narrowing in the clavicular-first rib angle, patients should be followed carefully by chest X-rays every 4 weeks. Whenever possible, the system should be removed within 6 months following insertion.
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Klotz et al. (1996) conducted a case report in Catheter fracture (n=2). Totally implantable subclavian venous access devices was evaluated on Catheter fracture. Catheter fracture is a rare complication of totally implantable subclavian venous access devices, with a literature incidence of 0-2.1%, and can be preceded by the radiological pinch-off sign.
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