CLINICAL CASES   

Giornale Italiano di Chirurgia Vascolare 2002 December;9(4):389-99

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English, Italian

Endovascular technique as therapy of choice in complicated Port-a-Cath catheter use

Rivellini C. ¹, Ventura M. ¹, Gallucci M. ², Marsili L. ², Spartera C. ¹

¹ Chair and Specializing School of Vascular Surgery University of L’Aquila, L’Aquila, Italy 2 Department of Imaging Diagnostics University of L’Aquila, L’Aquila, Italy

­Despite the sim­plicity and ­safety of cen­tral ­venous cath­eter implan­ta­tion tech­niques (e.g. ­Port-a-­Cath), com­pli­ca­tions may ­arise ­during the use of cath­eter ­systems. Arte­rial punc­ture and can­nu­la­tion or cath­eter frac­ture and dis­lo­ca­tion ­have ­been ­described. Endo­vas­cular treat­ment can be the tech­nique of ­choice in ­many ­cases ­where treat­ment by con­ven­tional sur­gery may ­carry a ­higher ­risk of com­pli­ca­tions ­related ­also to ­poor gen­eral con­di­tions of ­patients. The ­authors ­describe 3 com­pli­cated ­cases ­after ­Port-a-­Cath deploy­ment. One ­patient had an iat­ro­genic sub­cla­vian per­fo­ra­tion ­with the cath­eter ­inserted in the sub­cla­vian ­artery and was ­treated by a 12-mm Hemo­bahn ­stent-­graft deploy­ment ­after sur­gical expo­sure of the sub­cla­vian ­artery. In 2 ­other ­cases a cath­eter frag­ment was ­retrieved ­with a ­Goose-­Neck ­device via per­cut­aneous intra­ve­nous ­route. The ­good tech­nical and clin­ical out­come asso­ciated ­with the ­minor inva­sive­ness of the pro­ce­dure sug­gest ­that in ­many ­cases endo­vas­cular ­therapy can rep­re­sent not ­only an alter­na­tive ­option to con­ven­tional sur­gery but a ­choice indi­ca­tion for endo­vas­cular ­therapy.