Fujimoto Kazushi, Kasai Hajime, Sugiura Toshihiko, Tatsumi Koichiro
Department of Medicine, School of Medicine, Chiba University, Chiba, Chiba, Japan.
Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan.
BMJ Case Rep. 2017 Aug 1;2017:bcr-2017-221445. doi: 10.1136/bcr-2017-221445.
Patients undergoing chemotherapy usually undergo placement of a totally implantable venous access port (TIVAP), but TIVAP catheter fracture is rare. We encountered a case where flushing the TIVAP catheter became impossible because of resistance. A 61-year-old-woman underwent TIVAP placement. Although a chest X-ray revealed the fractured catheter had migrated into the right hilar area, the timing of the fracture was unclear. Four-dimensional computed tomography (4D-CT) showed that the tip of the fractured catheter was located at the anterior segmental artery of the right upper lobe and was immobile, with the remaining portion flapping with the blood flow. Transcatheter removal of the migrated catheter was judged to be possible and was performed successfully. 4D-CT may be useful as an appropriate approach in transcatheter removal of a migrated fractured catheter.
接受化疗的患者通常会植入全植入式静脉通路导管（TIVAP），但TIVAP导管断裂很少见。我们遇到了一例因阻力导致无法冲洗TIVAP导管的病例。一名61岁女性接受了TIVAP植入。尽管胸部X线显示断裂的导管已迁移至右肺门区域，但断裂时间尚不清楚。四维计算机断层扫描（4D-CT）显示，断裂导管的尖端位于右上叶前段动脉，位置固定，其余部分随血流摆动。经导管取出迁移的导管被认为可行并成功实施。4D-CT可能是经导管取出迁移的断裂导管的一种合适方法。
