Abstract

VIDAL, M. A.; GARCIA-HERNANDEZ, R.  and  TORRES, L. M.. Spontaneous rupture of central venous catheter. Rev. Soc. Esp. Dolor [online]. 2006, vol.13, n.3, pp.164-166. ISSN 1134-8046.

Subcutaneous vascular access ports can be an alternative to conventional central venous lines, both for collection of blood samples and for the administration of intravenous therapies. In recent years, its use has become wider regardless of the possibility of risks and complications such as the rupture of the catheter. We report the case of a male patient diagnosed of oesophagous adenocarcinoma to whom a subcutaneous chamber catheter (Bard Port® Titanium Dome, catheter Groshong^®) for the administration of chemotherapy was implanted. One week afterwards, at the time of the first cycle of chemotherapy, the patient referred pain and signs of swelling at the implantation area. A routine x-ray control showed a rupture of the catheter at the costo-clavicular level with the distal end lodged in the superior vena cava. The findings were confirmed wit contrast x-ray. The reservoir and the proximal end of the catheter were removed in the operation room. The distal end of the catheter was removed through right femoral catheterism with a gooseneck catheter. The right subclavian vein is the central line most frequently chosen; the location of the device adjacent to the ribs and close to bone structures can facilitate the tear of its components. Diagnosis of central catheters rupture is based upon radiologic features such as the pinch off sign, caused by the friction of the catheter between the first rib and the clavicula. This complication merits an early diagnosis and the quick removal of the catheter. The distal end must also be withdrawn through a percutaneous endovas-cular technique when possible.

Keywords : port-a-cath; complications; rupture; interventional radiology.

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