Contrast extravasation from Port-A-Cath

Case contributed by Dr Dayu Gai

Presentation

Soft tissue swelling over the anterior chest during flushing of Port-A-Cath.

Patient Data

Age: 80 years
Gender: Female
Fluoroscopy

A Port-A-Cath is projected over the left lung, with the tip located in the superior vena cava.

On injection of contrast, the catheter lumen opacifies, but does not ever the SVC. Instead, contrast pools around the subcutaneous tract and exits into the subcutaneous chest tissue.

Case Discussion

A Port-A-Cath is an implantable vascular access device used for medium to long term intravenous access, e.g. in patients requiring chemotherapy.

Although they can be left in situ for years, complications can include infection, extravasation and migration of the Port-A-Cath.

In this patient, the port was removed and a replacement device was inserted.

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