Gebauer Bernhard, Teichgräber Ulf Karl, Podrabsky Petr, Werk Michael, Hänninen Enrique Lopez, Felix Roland
Department of Radiology, Charité, Universitätsmedizin-Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Cardiovasc Intervent Radiol. 2007 Jul-Aug;30(4):668-74. doi: 10.1007/s00270-007-9073-y. Epub 2007 May 29.
The purpose of this study was to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips.
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.
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.
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.
本研究旨在评估对移位/位置不当的中心静脉端口导管进行放射介入纠正的效果。
本回顾性分析纳入了30例端口导管尖端移位/位置不当的患者。为了观察导管通畅情况,进行了增强造影的端口导管系列检查,随后使用各种5F血管造影导管(猪尾导管;Sos Omni)、鹅颈圈套器或其组合经股进行端口导管纠正。
1例患者导管尖端自发复位。29例患者中的27例(93%)放射介入端口导管纠正成功。2例患者无法纠正端口导管位置不当,原因是无法捕获导管尖端或导管走行中的导管,可能是由于纤维蛋白鞘形成导致导管附着于血管壁。纠正后未观察到断开或端口导管功能障碍。
我们得出结论,对于移位的导管尖端,放射介入端口导管纠正是一种微创替代方法,可替代端口拔除和重新植入。对于有纤维蛋白鞘和/或血栓形成的患者,端口导管纠正通常更具挑战性。