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A Rare Late Complication of Port Catheter Implantation: Embolization of the Catheter

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Letter TJH R2 Submitted: 30 March 2017 Accepted: 20 April 2017 A Rare Late Complication of Port Catheter Implantation: Embolization of the Catheter Nadir Görülen Bir Port Kateter Geç Komplikasyonu:
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Letter TJH R2 Submitted: 30 March 2017 Accepted: 20 April 2017 A Rare Late Complication of Port Catheter Implantation: Embolization of the Catheter Nadir Görülen Bir Port Kateter Geç Komplikasyonu: Kateter Embolizasyonu Cengiz Bayram İstanbul Kanuni Sultan Suleyman Research and Training Hospital - Pediatric Hematology, Istanbul, Turkey T: Işık Odaman Al, Cengiz Bayram Gizem Ersoy Kazım Öztarhan İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi - Pediatric Cardiology, İstanbul, Turkey Alper Güzeltaş Mehmet Akif Ersoy Thoracic and Cardiovascular Training and Research Hospital - Pediatric Cardiology, İstanbul, Turkey Taner Kasar İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and research Hospital - Pediatric Cardiology, İstanbul, Turkey Ezgi Uysalol Başak Koç To the Editor, Ali Ayçiçek Nihal Özdemir Children with cancer need long-term venous access due to the long duration of therapy. Longterm totally implantable port devices (TIPDs) are widely used in these patients for administration of chemotherapeutic agents, parenteral nutrition, fluids, and blood products [1,2]. Fracture and embolism of TIPDs are rare complications but may cause serious results and mortality, including pulmonary artery embolism, sepsis, arrhythmias, and perforation of the caval vein [3,4,5]. Herein, we present a 9-year-old male patient with pre-b acute lymphoblastic leukemia who was admitted to the outpatient pediatric hematology and oncology clinic at the 13th month of maintenance therapy due to new onset of non-flushing catheter. The patient had no other complaints. On posterior anterior chest X-ray, the catheter was found to be disconnected from its reservoir (Figure 1). Echocardiography and thorax computed tomography angiography of the patient revealed the embolization of the catheter to the left pulmonary artery (Figure 2). The embolized catheter was removed using an interventional endovascular procedure under general anesthesia through the femoral vein by an interventional cardiologist (Figure 3). Our case report highlights a rarely encountered complication of TIPDs, which may be undiagnosed due to its rarity and lack of symptoms in some patients, leading to serious complications. Keywords: Acute lymphoblastic leukemia, Catheter, Complication Anahtar Sözcükler: Akut lenfoblastik lösemi, Kateter, Komplikasyon References 1. Kurul S, Saip P, Aydin T. Totally implantable venous-access ports: local problems and extravasation injury. Lancet Oncol 2002;3: Intagliata E, Basile F, Vecchio R. Totally implantable catheter migration and its percutaneous retrieval: case report and review of the literature. G Chir 2017;37: Kassar O, Hammemi R, Ben Dhaou M, Kammoun S, Elloumi M. Spontaneous fracture and migration of a totally implanted port device to pulmonary artery in acute leukemia child. J Pediatr Hematol Oncol 2017;39:e103-e105. rre ct ed pr oo f 4. Surov A, Buerke M, John E, Kösling S, Spielmann RP, Behrmann C. Intravenous port catheter embolization: mechanisms, clinical features, and management. Angiology 2008;59: Ribeiro RC, Monteiro AC, Menezes QC, Schettini ST, Vianna SM. Totally implantable catheter embolism: two related cases. Sao Paulo Med J 2008;126: un co Figure 1. Chest X-ray showing disconnection of the catheter from its reservoir. Figure 2. Thorax computed tomography angiography of the patient showing the embolization of the catheter to the left pulmonary artery. Figure 3. Removal of the catheter with an interventional endovascular procedure.
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