Misplacement of a Port Catheter: A Differentiated View.
Christoph EversAngelos GazisWendy Thuss-PatianceAlbrecht KretzschmarPublished in: Case reports in radiology (2017)
Clinical radiological controls after the insertion of central venous catheters (CVC) are of high importance. Misplacement of the CVC, outside of large vessels, as described in our first case, occurs in more than 7% of cases and may be associated with life-threatening events. A persistent left-sided superior vena cava (PLSSVC) occurs in 0.3-0.5% of the standard population. In one of the cases a CT scan of the chest showed the catheter in a PLSSVC. Neoadjuvant radiochemotherapy was indicated in a patient with an adenocarcinoma of the oesophagus. Under hospitalised monitoring, full-dose chemotherapy was given. Consequences for the patients arise when the findings are known for future interventions. If a PLSSVC is expected and a CVC is to be inserted, the venous return to the heart should be evaluated first, to preclude a possible backflow to the left atrium. With this constellation, a right-to-left shunt can be expected in in 10% of cases. Affected patients face a high risk of developing cardioembolic events.
Keyphrases
- end stage renal disease
- locally advanced
- newly diagnosed
- ejection fraction
- chronic kidney disease
- computed tomography
- heart failure
- prognostic factors
- squamous cell carcinoma
- rectal cancer
- radiation therapy
- lymph node
- pulmonary artery
- contrast enhanced
- atrial fibrillation
- minimally invasive
- pulmonary embolism
- robot assisted
- community acquired pneumonia