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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.