A delayed complication of a port-a-cath insertion via subclavian venous access: Case report of a “pinch-off syndrome”

• Published in: International journal of surgery case reports Vol. 94; p. 107039
• Main Authors: Caiazzo, Marco, Golino, Ludovica, Addeo, Raffaele, Fardello, Francesco, Russo, Gianmarco, Imperatore, Francesco
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.05.2022; Elsevier
• Subjects: Anesthesiology; Case Report; Complications management; Pinch-off-syndrome; Porth-a-cath; Vascular access; Complications management; Porth-a-cath; Case report; Pinch-off-syndrome; Vascular access; Anesthesiology
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2022.107039

Port-a-caths are long-stay central catheters often used for chemotherapy or parenteral nutrition. The implantation of a port-a cath, despite being involved in routine procedures, is also associated with immediate and delayed complications. Complications are rare but must be known and managed by operators. A delayed complication related to the presence of a port-a-cath, consisting in the fragmentation of the catheter, has been reported, in a 63-years-old female patient. The port was placed via subclavian venous access and affected by pinch-off syndrome, which resulted in catheter malfunction and then in fragmentation from compression by the subclavius-costoclavicular complex. The onset symptom was device malfunction. The focus in the management of this rare but possible complication was the quick removal of the device and of the catheter fragment in the endovascular lumen with collaboration between different medical specialists. •Port-a-cath implantation is an usual procedure in critically ill patients.•There are rare but possible complications related to the port-a-cath implantation that it is necessary to know and know how to manage.•a rare, delayed complication is the so-called "pynch-off syndrome", when the port catheter can be "pinched" to rupture and embolization between the clavicle and first rib.•Patients should immediately report symptoms related to the malfunction of the port-a-cath (burning at the infusion, negative aspiration tests, etc.).•It is essential to quickly manage the rupture and consequent embolization of a port-a-cath catheter, as the patient is exposed to serious complications.•a collaboration between different specialists is the key for the rapid and complete resolution of a delayed complication of a port.