Migração para veia hepática de cateter totalmente implantável para quimioterapia em paciente com carcinoma de mama: relato de caso
Hepatic vein migration of a totally implantable venous access port-a-cath for chemotherapy in a breast carcinoma patient: case report
Augusto Cesar Maia Rio Lima Silveira; Paula Shelda Fonseca Fernandes; Danilo Rafael da Silva Fontinele; Rafael Everton Assunção Ribeiro da Costa; José Eduardo Prado Araújo; Wilson de Oliveira Sousa Junior; Sabas Carlos Vieira
A totally implantable venous access port (TIVAP) is used for chemotherapy administration. Venous port migration to the systemic circulation occurs in less than 1% of complications. The aim of this study is to describe a case of TIVAP migration to the hepatic vein. A 44-year-old female patient with breast cancer was prescribed neoadjuvant chemotherapy. A port-a-cath was surgically implanted for chemotherapy. During the port puncture procedure, blood returned normally when aspirated. When the port was first accessed and flushed with saline solution, swelling was observed at the port site and blood could no longer be aspirated. A chest radiography showed catheter embolization in the region of the hepatic vein. The catheter was retrieved using a snare technique (without complications) and the patient was discharged the next day. The care team should be alert to possible TIIVAP malfunction.
1 Garcez BBD, Eulálio WMN Fo, Vieira SC. Embolização para veia cava inferior de cateter totalmente implantável para quimioterapia. J Vasc Bras. 2018;17(1):89-92.
2 Fonseca IY, Krutman M, Nishinari K, et al. Brachial insertion of fully implantable venous catheters for chemotherapy: complications and quality of life assessment in 35 patients. Einstein (Sao Paulo). 2016;14(4):473-9.
3 Motta Leal JM Fo, Carnevale FC, Nasser F, et al. Endovascular techniques and procedures, methods for removal of intravascular foreign bodies. Rev Bras Cir Cardiovasc. 2010;25(2):202-8. PMid:20802912.
4 Danski MTR, de Amorim SD, de Oliveira GLR, Pedrolo E, da Silva SR, Greboge TML. Infectious complications associated with the totally implantable central venous catheter. J Nurs UFPE on line. 2017;11(12):5049-58.
5 Cakır F, Geze S, Ozturk MH, Dınc H. Percutaneous endovascular removal of intracardiac migrated port A catheter in a child with acute lymphoblastic leukemia. Braz J Anesthesiol. 2014;64(4):275-7.
6 Xu H, Chen R, Jiang C, et al. Implanting totally implantable venous access ports in the upper arm is feasible and safe for patients with early breast cancer. J Vasc Access. 2020;21(5):609-14.
7 Skelton WP 4th, Franke AJ, Welniak S, et al. Investigation of complications following port insertion in a cancer patient population: a retrospective analysis. Clin Med Insights Oncol. 2019;13:1179554919844770.
8 Tumay LV, Guner OS. Availability of totally implantable venous access devices in cancer patients is high in the long term: a seven-year follow-up study. Support Care Cancer. 2021;29(7):3531-8.
9 Voog E, Campion L, du Rusquec P, et al. Totally implantable venous access ports: a prospective long-term study of early and late complications in adult patients with cancer. Support Care Cancer. 2018;26(1):81-9.