Carr M E
Department of Medicine, Medical College of Virginia, Richmond.
Angiology. 1989 Apr;40(4 Pt 1):319-23. doi: 10.1177/000331978904000413.
Two cases of catheter embolization from implanted venous access devices are reported and the available literature is reviewed. The catheter from an implanted venous access device migrated into the right heart after slippage of the O-ring, which attaches the catheter to the infusion port. The distal 6 cm of an infusion port catheter embolized to the right heart after spontaneous fracture of the catheter at the point where it passed between the clavicle and first rib. Both catheters were removed percutaneously without complication. Risk factors for embolization were apparent on x-ray films with evidence of O-ring slippage in 1 case an obvious kinking of the catheter in the other. Symptoms of embolization included chest discomfort, right upper quadrant pain, and nausea. In 1 case, an extra heart sound, initially thought to be an S3, disappeared when the catheter was removed.
本文报告了两例植入式静脉通路装置导管栓塞的病例,并对现有文献进行了综述。连接导管与输液端口的O形环滑脱后,植入式静脉通路装置的导管移入右心。一根输液端口导管在锁骨和第一肋骨之间穿过处自发断裂后,其远端6厘米栓塞至右心。两根导管均经皮取出,无并发症。栓塞的危险因素在X线片上明显可见,1例有O形环滑脱的证据,另一例有导管明显扭结。栓塞症状包括胸部不适、右上腹疼痛和恶心。在1例中,最初被认为是S3的额外心音在导管取出后消失。