A Case of Pinch-off Syndrome caused by Clavicular Fracture

Satoshi Kobayashi, Shinsuke Iyomasa, Naoki Sawasaki, Takanori Kyokane and Masao Matsuda

Department of Surgery, Chukyo Hospital

A 73-year-old man undergoing chemotherapy via an implanted central venous catheter port (CV port) for advanced colon cancer as an outpatient suffered a right clavicular fracture. CV port use and chemotherapy were continued for three cycles because a chest X-ray film indicated that the catheter was patent and injection into the catheter was smooth. Subcutaneous swelling occurred, however, just after the next cycle was started, and a chest X-ray the catheter to have ruptured in the left pulmonary artery, necessitating emergency catheter removal via the right femoral vein. The number of patients undergoing outpatient chemotherapy using implanted CV ports is expected to increase, together with the incidence of CV port breakage, raising questions about catheter retrieval. Any decision on removal should be based on detailed consideration including fluoroscopical examination.

Key words
catheter fracture, central venous catheter port, clavicular fracture

Reprint requests
Satoshi Kobayashi Department of Surgery, Nagoya Teishin Hospital
2-2-5 Izumi, Higashi-ku, Nagoya, 461-8798 JAPAN

Accepted
September 26, 2007

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