Misplacement of a Port Catheter: A Differentiated View

Clinical radiological controls after the insertion of central venous catheters (CVC) are of high importance. Misplacement of the CVC, outside of large vessels, as described in our first case, occurs in more than 7% of cases and may be associated with life-threatening events. A persistent left-sided...

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Main Authors: Christoph Evers, Angelos Gazis, Wendy Thuss-Patiance, Albrecht Kretzschmar
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Radiology
Online Access:http://dx.doi.org/10.1155/2017/1640431
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author Christoph Evers
Angelos Gazis
Wendy Thuss-Patiance
Albrecht Kretzschmar
author_facet Christoph Evers
Angelos Gazis
Wendy Thuss-Patiance
Albrecht Kretzschmar
author_sort Christoph Evers
collection DOAJ
description Clinical radiological controls after the insertion of central venous catheters (CVC) are of high importance. Misplacement of the CVC, outside of large vessels, as described in our first case, occurs in more than 7% of cases and may be associated with life-threatening events. A persistent left-sided superior vena cava (PLSSVC) occurs in 0.3–0.5% of the standard population. In one of the cases a CT scan of the chest showed the catheter in a PLSSVC. Neoadjuvant radiochemotherapy was indicated in a patient with an adenocarcinoma of the oesophagus. Under hospitalised monitoring, full-dose chemotherapy was given. Consequences for the patients arise when the findings are known for future interventions. If a PLSSVC is expected and a CVC is to be inserted, the venous return to the heart should be evaluated first, to preclude a possible backflow to the left atrium. With this constellation, a right-to-left shunt can be expected in in 10% of cases. Affected patients face a high risk of developing cardioembolic events.
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spelling doaj-art-9f9b045864e94e41b7b96dcd6559864c2025-08-20T03:38:30ZengWileyCase Reports in Radiology2090-68622090-68702017-01-01201710.1155/2017/16404311640431Misplacement of a Port Catheter: A Differentiated ViewChristoph Evers0Angelos Gazis1Wendy Thuss-Patiance2Albrecht Kretzschmar3Department of Radiation Oncology, University of Halle, Halle (Saale), GermanyDepartment of Radiology, St. Georg Hospital Leipzig, Leipzig, GermanyDepartment of Pneumology, Protestant Lung Hospital Berlin, Berlin, GermanyDepartment of Medical Oncology, St. Georg Hospital Leipzig, Leipzig, GermanyClinical radiological controls after the insertion of central venous catheters (CVC) are of high importance. Misplacement of the CVC, outside of large vessels, as described in our first case, occurs in more than 7% of cases and may be associated with life-threatening events. A persistent left-sided superior vena cava (PLSSVC) occurs in 0.3–0.5% of the standard population. In one of the cases a CT scan of the chest showed the catheter in a PLSSVC. Neoadjuvant radiochemotherapy was indicated in a patient with an adenocarcinoma of the oesophagus. Under hospitalised monitoring, full-dose chemotherapy was given. Consequences for the patients arise when the findings are known for future interventions. If a PLSSVC is expected and a CVC is to be inserted, the venous return to the heart should be evaluated first, to preclude a possible backflow to the left atrium. With this constellation, a right-to-left shunt can be expected in in 10% of cases. Affected patients face a high risk of developing cardioembolic events.http://dx.doi.org/10.1155/2017/1640431
spellingShingle Christoph Evers
Angelos Gazis
Wendy Thuss-Patiance
Albrecht Kretzschmar
Misplacement of a Port Catheter: A Differentiated View
Case Reports in Radiology
title Misplacement of a Port Catheter: A Differentiated View
title_full Misplacement of a Port Catheter: A Differentiated View
title_fullStr Misplacement of a Port Catheter: A Differentiated View
title_full_unstemmed Misplacement of a Port Catheter: A Differentiated View
title_short Misplacement of a Port Catheter: A Differentiated View
title_sort misplacement of a port catheter a differentiated view
url http://dx.doi.org/10.1155/2017/1640431
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