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Clinical Images  |   August 2014
Central Venous Catheter Fracture
Author Affiliations & Notes
  • Joseph R. Peters, DO, RDMS
    From the University of Illinois College of Medicine at Peoria and the Department of Emergency Medicine at OSF Saint Francis Medical Center in Peoria, Illinois
  • Address correspondence to Joseph R. Peters, DO, RDMS, Department of Emergency Medicine, OSF Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL 61637-0001. E-mail: joseph.r.peters@osfhealthcare.org  
Article Information
Emergency Medicine / Imaging / Clinical Images
Clinical Images   |   August 2014
Central Venous Catheter Fracture
The Journal of the American Osteopathic Association, August 2014, Vol. 114, 665. doi:10.7556/jaoa.2014.133
The Journal of the American Osteopathic Association, August 2014, Vol. 114, 665. doi:10.7556/jaoa.2014.133
Web of Science® Times Cited: 72
An 18-year-old woman presented with a 1-day history of edema and erythema associated with a port central venous access device of the anterior left chest wall. The patient reported difficulty with catheter flushing for 2 days. Medical history included severe gastroparesis requiring placement of the catheter 2 months earlier for routine intravenous hydration. Single-view plain-film radiograph of the chest (pictured) suggested a fractured catheter (arrow) with embolization to the left pulmonary artery (circle). The patient received a diagnosis of pinch-off syndrome (POS), or shearing forces between the clavicle and first rib. An endovascular retrieval of the catheter fragment was performed, and the patient recovered with no complications. 
Central venous catheter fracture with embolization is a rare but potentially serious complication.1,2 Proximal fracture is most common and may be associated with POS.3 Current management for POS includes more lateral replacement of the catheter in the subclavian vein or into the internal jugular vein.4 With the increasing use of long-term catheters, physicians should monitor for these complications. 
   Financial Disclosures: None reported.
 
   Support: None reported.
 
References
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