Shimizu Atsushi, Lefor Alan, Nakata Manabu, Mitsuhashi Umehachi, Tanaka Masahiro, Yasuda Yoshikazu
Department of Surgery, Koganei Central Hospital, Koganei 2-4-3, Shimotsuke, Tochigi 329-0414, Japan; Department of Surgery, Jichi Medical University, Yakushiji 3311-1, Tochigi 329-0498, Japan.
Department of Surgery, Jichi Medical University, Yakushiji 3311-1, Tochigi 329-0498, Japan.
Int J Surg Case Rep. 2014;5(5):219-21. doi: 10.1016/j.ijscr.2014.02.001. Epub 2014 Mar 20.
Fracture and embolization of central venous catheters placed via the subclavian approach is well recognized, but fractured catheters placed via the internal jugular vein are extremely rare.
A 65-year-old man presented with a catheter embolus after placement of a central venous port using the internal jugular approach undertaken to administer adjuvant chemotherapy for colon cancer with lung metastases. Goose neck and conformational loop snares were successfully used to percutaneously retrieve the severed catheter, which had migrated to the right ventricle.
Catheter fracture may occur even after placement via the internal jugular approach and may be underestimated because it is often asymptomatic. Interventional radiology techniques using goose-neck and conformational loop snares may be useful to retract an intravascular foreign body.
Imaging studies such as a chest X-ray are mandatory to check that the catheter tip is in the appropriate position during the entire follow-up period even if it was placed through the internal jugular vein.
经锁骨下途径置入的中心静脉导管发生断裂和栓塞已广为人知,但经颈内静脉置入的导管断裂极为罕见。
一名65岁男性,因结肠癌伴肺转移接受辅助化疗,采用颈内静脉途径置入中心静脉端口后出现导管栓子。成功使用鹅颈圈套器和顺应性圈套器经皮取出迁移至右心室的断裂导管。
即使经颈内静脉途径置入导管后也可能发生断裂,且由于通常无症状可能被低估。使用鹅颈圈套器和顺应性圈套器的介入放射学技术可能有助于取出血管内异物。
即使导管是经颈内静脉置入的,在整个随访期间进行胸部X线等影像学检查以检查导管尖端位置是否合适是必不可少的。