Spontane Ruptur und Embolisation: Eine seltene Komplikation nach Port-Katheter-Implantation

HISTORY AND CLINICAL FINDINGS: A 70-year-old male patient had a venous port catheter implanted into his right subclavian vein for neoadjuvant radio-chemotherapy of a rectal carcinoma (T3N0N0). Due to the patient's difficult venous access the catheter was left in situ after treatment. 31 weeks later he was admitted to the hospital because of parasternal and subclavicular pain. INVESTIGATIONS: Physical examination and an electrocardiogram revealed no abnormalities. A chest x-ray was performed. DIAGNOSIS, TREATMENT AND COURSE: The chest x-ray showed a normal location of the port-system but the tip of the catheter had embolized into the right atrium. The embolized fragment was extracted with a loop-snare technique and the reservoir of the system was removed under local anaesthesia without any complications. CONCLUSIONS: Despite its frequent use intravascular embolization of catheter fragments from implantable venous port-catheter systems present a rare but potentially life-threatening complication. Any implanted catheters should therefore be removed after completion of treatment or the system's integrity should be monitored on a regular basis.