World Journal of
Pharmaceutical and Life Sciences

INADVERTENT PORT CATHETERIZATION INTO ABERRANT THORACIC VEIN: A CASE REPORT

Li Peng, Hao Zhang, Gang Liu and Xin Chen*

ABSTRACT

PATIENT AND OBSERVATION A 70-year-old female diagnosed with right breast cancer. Postoperative systemic chemotherapy is planned. She placed an totally implantable venous access ports (TIVAP) at our hospital in September 23rd 2021. The left internal jugular vein was selected as the puncture path under routine ultrasound guidance. The initial depth of catheter placement is 13-14cm. During the operation, the push injection was smooth but blood return was slow. After adjusting depth to 11-12cm, the catheter function recovered well. She took Chest X-ray after 1 hour(Fig. 1). The result showed the end of catheter was located at the left margin of thoracic vertebra 6th.Then we found dysfunction of the catheter, difficultly in injection and suction. The patient did not have chest tightness and pain. We considered the abnormal position of the catheter tip, it was not at the opening of the superior vena cava of the right atrium. The catheter tip was successfully adjusted under digital subtraction angiography (DSA). The contrast medium extended downward along the catheter on the left side of the spine during the operation(Fig. 2). The contrast medium was injected into the small transverse branch on the right side at the level of the 6th-7th thoracic vertebra approximately. There was no obvious contrast medium filling below this level. The catheter was located in the superior vena cava at the opening of the right atrium finally. The patient can use the port for follow-up chemotherapy.

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