Koller M, Papa M Z, Zweig A, Ben-Ari G
Department of Surgery and Surgical Oncology, Chaim Sheba Medical Center, Tel Aviv University Sackler Medical School, Tel Hashomer, Israel.
J Surg Oncol. 1998 Jul;68(3):166-8. doi: 10.1002/(sici)1096-9098(199807)68:3<166::aid-jso6>3.0.co;2-3.
Implanted central venous access ports are frequently used. Spontaneous break and catheter transection are serious but rare complications of permanent subclavian catheters. We report our experience with this serious complication and identify possible warning signs.
Between 1990 and 1996, 285 permanent subclavian catheters were placed at the Sheba Medical Center, Tel Hashomer, Israel.
We evaluated the patient population for this complication and searched for possible warning signs. A total of 12 patients (4.2%) with this complication were identified, 8 with transection and distal embolization and 4 with a partial tear only. The pinch-off sign was noted as an early warning in only 5 patients. All other patients developed symptoms only immediately before the diagnosis of this complication. The mean duration from insertion to identification of tear or transection was 9.6 months (range 1-24 months).
Awareness and clinical suspicion are most important in identification and prevention of this serious complication. Catheters should be taken out when treatment is completed or after 12 months in order to prevent catheter breaks.
植入式中心静脉通路端口应用广泛。永久性锁骨下导管的自发性断裂和导管横断是严重但罕见的并发症。我们报告了我们处理这一严重并发症的经验，并确定了可能的警示信号。
1990年至1996年期间，以色列特拉哈希默的谢巴医疗中心共放置了285根永久性锁骨下导管。
我们评估了发生该并发症的患者群体，并寻找可能的警示信号。共识别出12例（4.2%）发生该并发症的患者，8例导管横断并远端栓塞，4例仅出现部分撕裂。仅5例患者出现夹闭征作为早期警示。所有其他患者仅在该并发症诊断前即刻出现症状。从导管插入到发现撕裂或横断的平均时间为9.6个月（范围1 - 24个月）。
在识别和预防这一严重并发症方面，意识和临床怀疑最为重要。治疗完成后或12个月后应拔除导管，以防止导管断裂。
