• Alexey Surov, Karin Jordan, Michael Buerke, Monica Persing, Bettina Wollschlaeger, and Curd Behrmann.
• Department of Radiology, Martin-Luther-University Halle/Wittenberg, Halle/Saale, Germany.
• Support Care Cancer. 2006 May 1;14(5):479-83.

Goals Of WorkEmbolization of venous catheter fragments to the pulmonary vasculature is a very rare form of pulmonary embolism which is only sporadically reported in the literature. The incidence and clinical picture of this complication are unknown.Patient And MethodsIn this retrospective analysis between 1999 and 2004, in our clinic, 1,014 port catheters were implanted. In this 5-year period, the patients' files were screened for the incidence of pulmonary embolism of catheter fragments and the accompanying complication rate.Main ResultsIn 11 patients, port catheter dislodgment and embolism into the pulmonary artery occurred. In all the patients' port examination by fluoroscopy, catheter dislocation and embolization were shown. In these 11 patients, no obvious clinical signs indicating dislocation of catheter fragments into the pulmonary circulation were found. None of these patients demonstrated respiratory symptoms. Heart rate, blood pressure, respiration frequency, and even oxygen saturation were normal. In 7 of the 11 patients, malfunction of port catheter was the first indicator of catheter dislocation. In four patients, embolized catheter fragments were an incidental finding. The main cause of catheter embolization was the pinch off syndrome. All embolized catheter fragments were retrieved by a 'goose-neck' snare without complication.ConclusionThese results suggest that the migration of fractured catheter into the pulmonary artery occurs in 1% of the central port catheter implantation. It is often asymptomatic, and malfunction of the catheter may be the first sign of this complication. The pinch off syndrome might be prevented by using the internal jugular vein or by implantation of the port catheter more laterally in the subclavian vein.

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