Port-a-Cath™ partial rupture in a low-grade pinch-off syndrome

Eizaga Rebollar, R.; García Palacios, M.V.; Pernia Romero, A.; Torres Morera, L.M.

doi:10.1016/j.redare.2018.06.005

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Slight kink between clavicle and first rib, no luminal narrowing or rupture (grade 1pinch-off syndrome). Tip of the catheter in the junction of the superior cava-right atrium. (B) Chest X-ray (contrast): extravasation of contrast in the area of kinking and reduced flow in the distal segment and tip of the catheter." ] ] ] "textoCompleto" => "A patient with uncomplicated Port-a-Cath® implantation 4 months previously who, after four sessions of chemotherapy, presented clavicular pain during infusion in the last two sessions. There were no signs of local inflammation, blood was extracted and saline flush was performed without pain or local oedema. Two radiographs were requested: one simple and another with contrast injection through the device (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Pinch-off syndrome occurs when a subclavian central venous catheter is compressed and/or sheared as it passes between the clavicle and the first rib; the more medial the subclavian vein insertion site (narrower costoclavicular angle), the more frequent the syndrome. Hinke's classification is: grade 0, normal path of catheter; grade 1, abrupt change in course with no luminal narrowing; grade 2, abrupt change in course with luminal narrowing (risk of catheter fracture); grade 3, complete catheter fracture with embolization of the distal segment (risk of arrhythmia, endocarditis, cardiac perforation and pulmonary embolism)." 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ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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Vol. 65. Issue 7.