Pinch off syndrome

Case contributed by Dr Jayanth Keshavamurthy

Presentation

63-year-old female with pancreatic carcinoma metastatic to liver who underwent placement of a Port-A-Cath via the right subclavian vein. On last chemotherapy administration swelling and pain was noted in the soft tissue around the port reservoir and catheter associated with chemotherapy administration. Image guided evaluation of the Port-A-Cath has been requested.

Patient Data

Age: 63
Gender: Female
Modality: Fluoroscopy

There was difficulty to aspirate the port; contrast injection demonstrates 2 separate breaks in the catheter: In the catheter approximately 2 cm from the connection to the port reservoir and a larger break is noted near the right subclavian vein access site. In addition there is "pinch off" of the catheter at the right subclavian vein insertion site associated with movement of the medial right clavicle in respect to the right first rib.

Case Discussion

The port was removed and replaced with a new one,

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Case Information

rID: 40702
Case created: 30th Oct 2015
Last edited: 6th Nov 2015
Inclusion in quiz mode: Included

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