Rebahi H, El Adib A G, Mouaffak Y, El Hattaoui M, Chaara A, Sadek H, Khouchani M, Mahmal L, Younous S
Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
Rev Med Interne. 2015 Jan;36(1):42-6. doi: 10.1016/j.revmed.2013.08.008. Epub 2013 Sep 17.
Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries.
We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory.
We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it.
全植入式静脉通路端口在肿瘤患者治疗中起着至关重要的作用。然而，其使用偶尔可能导致导管断裂，导管尖端栓塞至肺动脉。
我们报告了4例患者出现的这种不常见但潜在严重的并发症。在这些患者中，端口采用锁骨下途径经皮插入锁骨下静脉。该副作用在3例患者中出现较晚。所有患者的导管断裂均无症状或症状轻微，由夹闭综合征引起。在心脏导管实验室通过经导管操作成功取出栓塞碎片。
我们回顾了文献以及最新的指南和建议，以详细阐述该并发症的临床放射学特征、可能原因，并讨论识别、处理和预防它的方法。
