Pinch off syndrome
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.
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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.
The port was removed and replaced with a new one,
- Andris DA, Krzywda EA, Schulte W et-al. Pinch-off syndrome: a rare etiology for central venous catheter occlusion. JPEN J Parenter Enteral Nutr. 1995;18 (6): 531-3. Pubmed citation
- Hinke DH, Zandt-Stastny DA, Goodman LR et-al. Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology. 1990;177 (2): 353-6. doi:10.1148/radiology.177.2.2217768 - Pubmed citation