Port implanted for chemo. Able to flush, not able to aspirate.
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Port was accessed in a sterile technique and contrast injected with mild resistance. Line tip is in the SVC with no kink of discontinuation.
On injection there is loss of normal jet from the tip with retrograde flow superiorly close to the catheter.
These findings are typical of fibrin sheath - this is the most common complication of any long-dwelling central venous catheter. It often forms a one-way valve effect with the presentation of "port/line flushes but does not aspirate" being quite typical.
There are a number of treatment options including fibrinolysis, catheter exchange over wire or angiographic stripping.
- Reddy AS, Lang EV, Cutts J et-al. Fibrin sheath removal from central venous catheters: an internal snare manoeuvre. Nephrol. Dial. Transplant. 2007;22 (6): 1762-5. doi:10.1093/ndt/gfm154 - Pubmed citation
- Funaki B. Central venous access: a primer for the diagnostic radiologist. AJR Am J Roentgenol. 2002;179 (2): 309-18. doi:10.2214/ajr.179.2.1790309 - Pubmed citation