Malpositioned permacath

Case contributed by Dr Henry Knipe

Presentation

PTCL for ASCT.

Patient Data

Age: 60
Gender: Female
X-ray

The proximal permacath tip is malpositioned in the right internal jugular vein. 

X-ray

Post manipulation in fluoroscopy

Permacath tips project in the SVC in an appropriate position for use. 

Case Discussion

Despite appropriate positioning at the cavo-atrial junction on supine fluoroscopy, the tip has migrated superiorly as demonstrated on the post-procedure erect chest x-ray. This often occurs in females with large breasts that migrate inferiorly when going from lying to sitting.

Fortunately in this case the permacath could be advanced under fluorscopy so the tips are in an appropriate position both supine and erect projections. 

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Case information

rID: 29930
Case created: 4th Jul 2014
Last edited: 21st Sep 2016
Inclusion in quiz mode: Included

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