Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.007116
Jornal Vascular Brasileiro
Case Report

Desconexão de cateter para quimioterapia: uma complicação rara?

Detachment of chemotherapy catheters: a rare complication?

Alexandre Faraco de Oliveira, Horácio de Oliveira Filho

Downloads: 0
Views: 322

Resumo

A utilização de cateteres totalmente implantáveis no tratamento quimioterápico constitui uma necessidade que acarreta o risco de múltiplas complicações, algumas inerentes à inserção do dispositivo e outras relacionadas ao próprio cateter. Relatamos três casos nos quais o cateter apresentou-se desacoplado de seu respectivo reservatório. No primeiro caso, ocorreu a desconexão do cateter de seu respectivo reservatório, e nos outros dois casos, verificou-se a fragmentação do cateter. Em todos os casos, foi necessária a retirada endovascular do cateter. Tal desfecho é apontado como raro, mas costuma estar presente na maioria das revisões e traz consigo o risco de complicações graves, ainda que frequentemente seja assintomático. É desejável o acompanhamento de pacientes que possuem tais cateteres a fim de que se possa detectar precocemente tais complicações e compreender os fatores que determinam o aparecimento dessas situações.

Palavras-chave

cateteres venosos centrais; falha de equipamento; dispositivo de acesso vascular

Abstract

Use of totally implantable catheters for chemotherapy treatment is a necessity, but one which brings with it risks of multiple complications, some inherent to insertion of the device and others related to the catheter itself. We describe three cases in which the catheter became disconnected from its reservoir. In the first case, the catheter became completely detached from its reservoir and in the second and third cases the catheter itself underwent fragmentation. In all three cases it was necessary to withdraw the endovascular catheter. This event is described as rare, but it tends to be present in the majority of reviews and it is associated with the risk of serious complications, even though it is often asymptomatic. It is advisable to follow-up patients who have these catheters implanted in order to detect these complications early and to enable understanding of the factors that cause these situations to occur.

Keywords

central venous catheters; equipment failure; vascular access devices.

References

1. Schiffer CA, Mangu PB, Wade JC, et al. Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31(10):1357-70. PMid:23460705. http://dx.doi.org/10.1200/JCO.2012.45.5733.

2. Bassi K, Pattanayak M, Pandey K, Giri A, Abraham S. Totally implantable venous access ports: Retrospective review of long-term complications in 81 patients. Indian J Cancer. 2012;49(1):114-8. PMid:22842178. http://dx.doi.org/10.4103/0019-509X.98934.

3. Debourdeau P, Farge D, Beckers M, et al. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost. 2013;11(1):71-80. PMid:23217208. http://dx.doi.org/10.1111/jth.12071.

4. El Hammoumi M, El Ouazni M, Arsalane A, El Oueriachi F, Mansouri H, Kabiri EH. Incidents and complications of permanent venous central access systems: a series of 1,460 cases. Korean J Thorac Cardiovasc Surg. 2014;47(2):117-23. PMid:24782960. http://dx.doi.org/10.5090/kjtcs.2014.47.2.117.

5. Reddy MA, Natarajan R. Epigenetic mechanisms in diabetic vascular complications. Cardiovasc Res. 2011;90(3):421-9. PMid:21266525. http://dx.doi.org/10.1093/cvr/cvr024.

6. Zerati A, Figueiredo T, Moraes R, et al. Risk factors for infectious and noninfectious complications of totally implantable venous catheters in cancer patients. J Vasc Surg Venous Lymphat Disord. 2016;4(2):200-5. PMid:26993868. http://dx.doi.org/10.1016/j.jvsv.2015.10.008.

7. Morales-Victorino N, Damas de los Santos F, Kuri-Ayache M, López-Aguilar C. Pinch-off syndrome: case report and review of the literature. Gac Med Mex. 2015;151(4):529-32. PMid:26290031.

8. Sugimoto T, Nagata H, Hayashi K, Kano N. Pinch-off syndrome: transection of implantable central venous access device. BMJ Case Rep. 2012;20:7-9. PMid:23203173.

9. Cho JB, Park IY, Sung KY, Baek JM, Lee JH, Lee DS. Pinch-off syndrome. J Korean Surg Soc. 2013;85(3):139-44. PMid:24020024. http://dx.doi.org/10.4174/jkss.2013.85.3.139.

10. Wildgruber M, Lueg C, Borgmeyer S, et al. Polyurethane versus silicone catheters for central venous port devices implanted at the forearm. Eur J Cancer. 2016;59:113-24. PMid:27023050. http://dx.doi.org/10.1016/j.ejca.2016.02.011.

11. Ko SY, Park SC, Hwang JK, Kim SD. Spontaneous fracture and migration of catheter of a totally implantable venous access port via internal jugular vein: a case report. J Cardiothorac Surg. 2016;11(1):50. PMid:27067705. http://dx.doi.org/10.1186/s13019-016-0450-y.

12. Faraj W, Zaghal A, El-Beyrouthy O, Kutoubi A. Complete catheter disconnection and migration of an implantable venous access device: the disconnected cap sign. Ann Vasc Surg. 2010;24(5):692-7. PMid:20413259. http://dx.doi.org/10.1016/j.avsg.2010.02.011.

13. Wassef AW, Kass M, Parmar G, Ravandi A. An unusual cause of ventricular tachycardia: Port-A-Cath fracture and embolization into the pulmonary artery. Heart Int. 2014;9(1):30-2. PMid:27004095.

14. Samad AM, Ibrahim YA. Complications of Port A Cath implantation: a single institution experience. Egypt J Radiol Nucl Med. 2015;907:11.

15. Ribeiro RC, Monteiro AC, Menezes QC, Schettini ST, Vianna SMR. Totally implantable catheter embolism: two related cases. Sao Paulo Med J. 2008;126(6):347-9. PMid:19274324. http://dx.doi.org/10.1590/S1516-31802008000600011.

16. Balsorano P, Galducci G, De Fanti I, Evans S, De Gaudio AR, Pelagatti C. Fractures of totally implantable central venous ports: more than fortuity. A three-year single center experience. J Vasc Access. 2014;15(5):391-5. PMid:25041921. http://dx.doi.org/10.5301/jva.5000261.

5ce5a81e0e882522398b4567 jvb Articles

J Vasc Bras

Share this page
Page Sections