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Radiological Interventions for Correction of Central Venous Port Catheter Migrations

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Abstract

Purpose

The purpose of this study was to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips.

Materials and Methods

Thirty patients with migrated/malpositioned port catheter tips were included in this retrospective analysis. To visualize the catheter patency a contrast-enhanced port catheter series was performed, followed by transfemoral port catheter correction with various 5-F angiographic catheters (pigtail; Sos Omni), gooseneck snares, or combinations thereof.

Results

One patient showed spontaneous reposition of the catheter tip. In 27 of 29 patients (93%), radiological-interventional port catheter correction was successful. In two patients port catheter malposition correction was not possible, because of the inability to catch either the catheter tip or the catheter in its course, possibly due to fibrin sheath formation with attachment of the catheter to the vessel wall. No disconnection or port catheter dysfunction was observed after correction.

Conclusions

We conclude that in migrated catheter tips radiological-interventional port catheter correction is a minimally invasive alternative to port extraction and reimplantation. In patients with a fibrin sheath and/or thrombosis port catheter correction is often more challenging.

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References

  1. Niederhuber JE, Ensminger W, Gyves JW, et al. (1982) Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 92(4): 706–712

    PubMed  CAS  Google Scholar 

  2. Yip D, Funaki B (2002) Subcutaneous chest ports via the internal jugular vein. A retrospective study of 117 oncology patients. Acta Radiol 43(4):371–375

    Article  PubMed  CAS  Google Scholar 

  3. Wagner HJ, Teichgraber U, Gebauer B, et al. (2003) Transjugular implantation of venous port catheter systems. RöFo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 175(11):1539–1544

    Article  PubMed  Google Scholar 

  4. Hata Y, Morita S, Morita Y, et al. (1998) Peripheral insertion of a central venous access device under fluoroscopic guidance using a peripherally accessed system (PAS) port in the forearm. Cardiovasc Intervent Radiol 21(3):230–233

    Article  PubMed  CAS  Google Scholar 

  5. McGee DC, Gould MK (2003) Preventing complications of central venous catheterization. N Engl J Med 348(12):1123–1133

    Article  PubMed  Google Scholar 

  6. Povoski SP (2000) A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients. Ann Surg Oncol 7(7):496–502

    Article  PubMed  CAS  Google Scholar 

  7. Trerotola SO, Kuhn-Fulton J, Johnson MS, et al. (2000) Tunneled infusion catheters: increased incidence of symptomatic venous thrombosis after subclavian versus internal jugular venous access. Radiology 217(1):89–93

    PubMed  CAS  Google Scholar 

  8. Funaki B, Szymski GX, Hackworth CA, et al. (1997) Interventional radiologic placement of chest wall ports: use of the internal jugular vein approach. J Vasc Interv Radiol 8(5):897

    PubMed  CAS  Google Scholar 

  9. Moureau N, Poole S, Murdock MA, et al. (2002) Central venous catheters in home infusion care: outcomes analysis in 50,470 patients. J Vasc Interv Radiol 13(10):1009–1016

    Article  PubMed  Google Scholar 

  10. Puel V, Caudry M, Le Metayer P, et al. (1993) Superior vena cava thrombosis related to catheter malposition in cancer chemotherapy given through implanted ports. Cancer 72(7):2248–2252

    Article  PubMed  CAS  Google Scholar 

  11. Vesely TM (2003) Central venous catheter tip position: a continuing controversy. J Vasc Interv Radiol 14(5):527–534

    PubMed  Google Scholar 

  12. Schutz JC, Patel AA, Clark TW, et al. (2004) Relationship between chest port catheter tip position and port malfunction after interventional radiologic placement. J Vasc Interv Radiol 15(6):581–587

    PubMed  Google Scholar 

  13. Collier PE, Blocker SH, Graff DM, et al. (1998) Cardiac tamponade from central venous catheters. Am J Surg 176(2):212–214

    Article  PubMed  CAS  Google Scholar 

  14. Huyghens L, Sennesael J, Verbeelen D, et al. (1985) Cardiothoracic complications of centrally inserted catheters. Acute Care 11(1):53–56

    PubMed  CAS  Google Scholar 

  15. Lewis CA, Allen TE, Burke DR, et al. (2003) Quality improvement guidelines for central venous access. J Vasc Interv Radiol 14(9; Pt 2):S231–S235

    PubMed  Google Scholar 

  16. Caers J, Fontaine C, Vinh-Hung V, et al. (2005) Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support Care Cancer 13(5):325–331

    Article  PubMed  Google Scholar 

  17. Kearns PJ, Coleman S, Wehner JH (1996) Complications of long arm-catheters: a randomized trial of central vs peripheral tip location. J Parenter Enteral Nutr 20(1):20–24

    CAS  Google Scholar 

  18. Connoly J (1982) Spreading cortical venous thrombosis due to infusion of hyperosmolar solution into the internal jugular vein. Br Med J 285:935

    Article  Google Scholar 

  19. O’Grady NP, Alexander M, Dellinger EP, et al. (2002) Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 51(RR-10):1–29

    PubMed  Google Scholar 

  20. Raad II, Luna M, Khalil SA, et al. (1994) The relationship between the thrombotic and infectious complications of central venous catheters. JAMA 271(13):1014–1016

    Article  PubMed  CAS  Google Scholar 

  21. Timsit JF, Farkas JC, Boyer JM, et al. (1998) Central vein catheter-related thrombosis in intensive care patients: incidence, risks factors, and relationship with catheter-related sepsis. Chest 114(1):207–213

    PubMed  CAS  Google Scholar 

  22. Silberzweig JE, Sacks D, Khorsandi AS, et al. (2003) Reporting standards for central venous access. J Vasc Interv Radiol 14(9; Pt 2):S443–S452

    PubMed  Google Scholar 

  23. Food, Drug Administration Task Force (1989) Precautions necessary with central venous catheters. FDA Drug Bull July:15–16

  24. Scott WL (1995) Central venous catheters. An overview of Food and Drug Administration activities. Surg Oncol Clin N Am 4(3):377–393

    PubMed  CAS  Google Scholar 

  25. National Association of Vascular Access Networks (1998) NAVAN position statement. J Vasc Access Devices 3:8–10

    Google Scholar 

  26. National Kidney Foundation (2001) K/DOQI Clinical Practice Guidelines for Vascular Access. Am J Kidney Dis 37(Suppl 1):S137–S181

    Google Scholar 

  27. Kowalski CM, Kaufman JA, Rivitz SM, et al. (1997) Migration of central venous catheters: implications for initial catheter tip positioning. J Vasc Interv Radiol 8(3):443–447

    PubMed  CAS  Google Scholar 

  28. Rutherford JS, Merry AF, Occleshaw CJ (1994) Depth of central venous catheterization: an audit of practice in a cardiac surgical unit. Anaesth Intensive Care 22(3):267–271

    PubMed  CAS  Google Scholar 

  29. Aslamy Z, Dewald CL, Heffner JE (1998) MRI of central venous anatomy: implications for central venous catheter insertion. Chest 114(3):820–826

    PubMed  CAS  Google Scholar 

  30. Albrecht K, Nave H, Breitmeier D, et al. (2004) Applied anatomy of the SVC-the carina as a landmark to guide central venous catheter placement. Br J Anaesth 92(1):75–77

    Article  PubMed  CAS  Google Scholar 

  31. Yoon SZ, Shin JH, Hahn S, et al. (2005) Usefulness of the carina as a radiographic landmark for central venous catheter placement in paediatric patients. Br J Anaesth 95(4):514–517

    Article  PubMed  CAS  Google Scholar 

  32. Nazarian GK, Bjarnason H, Dietz CA Jr, et al. (1997) Changes in tunneled catheter tip position when a patient is upright. J Vasc Interv Radiol 8(3):437–441

    Article  PubMed  CAS  Google Scholar 

  33. Forauer AR, Alonzo M (2000) Change in peripherally inserted central catheter tip position with abduction and adduction of the upper extremity. J Vasc Interv Radiol 11(10):1315–1318

    Article  PubMed  CAS  Google Scholar 

  34. van Dijk B, Bakker PM (1977) Appraisal of the dislocation of central venous catheter tips using subclavian and arm veins. Anaesthetist 26(3):138–140

    Google Scholar 

  35. Vazquez RM, Brodski EG (1985) Primary and secondary malposition of silicone central venous catheters. Acta Anaesthesiol Scand Suppl 81:22–26

    PubMed  CAS  Google Scholar 

  36. Collin GR, Ahmadinejad AS, Misse E (1997) Spontaneous migration of subcutaneous central venous catheters. Am Surg 63(4):322–326

    PubMed  CAS  Google Scholar 

  37. Hartnell GG, Wilde PH (1988) Nonsurgical repositioning of central venous catheters. Radiology 168(2):581

    PubMed  CAS  Google Scholar 

  38. Hartnell GG, Roizental M (1995) Percutaneous transfemoral repositioning of malpositioned central venous catheters. AJR 164(4):1003–1006

    PubMed  CAS  Google Scholar 

  39. Hartnell GG, Gates J, Suojanen JN, et al. (1996) Transfemoral repositioning of malpositioned central venous catheters. Cardiovasc Intervent Radiol 19(5):329–331

    PubMed  CAS  Google Scholar 

  40. de Kerviler E, Cyna-Gorse F, Douard MC, et al. (1996) Additional technique for repositioning central venous catheters. AJR 166(6):1496

    PubMed  Google Scholar 

  41. Lois JF, Gomes AS, Pusey E (1987) Nonsurgical repositioning of central venous catheters. Radiology 165(2):329–333

    PubMed  CAS  Google Scholar 

  42. Hawkins IF Jr, Paige RM (1983) Redirection of malpositioned central venous catheters. AJR 140(2):393–394

    PubMed  Google Scholar 

  43. Rasuli P, Hammond DI, Peterkin IR (1992) Spontaneous intrajugular migration of long-term central venous access catheters. Radiology 182(3):822–824

    PubMed  CAS  Google Scholar 

  44. Olcott EW, Gordon RL, Ring EJ (1989) The injection technique for repositioning central venous catheters: technical note. Cardiovasc Intervent Radiol 12(5):292–293

    Article  PubMed  CAS  Google Scholar 

  45. Carrasco CH, Richli WR, Charnsangavej C, et al. (1987) Repositioning misplaced central venous catheters. Cardiovasc Intervent Radiol 10(4):234–236

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Charité, Universitätsmedizin-Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Bernhard Gebauer, Ulf Karl Teichgräber, Petr Podrabsky, Michael Werk, Enrique Lopez Hänninen & Roland Felix

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  1. Bernhard Gebauer
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  2. Ulf Karl Teichgräber
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  3. Petr Podrabsky
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  4. Michael Werk
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  5. Enrique Lopez Hänninen
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  6. Roland Felix
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Correspondence to Bernhard Gebauer.

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Gebauer, B., Teichgräber, U.K., Podrabsky, P. et al. Radiological Interventions for Correction of Central Venous Port Catheter Migrations. Cardiovasc Intervent Radiol 30, 668–674 (2007). https://doi.org/10.1007/s00270-007-9073-y

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  • DOI: https://doi.org/10.1007/s00270-007-9073-y

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