Catheter fracture: a rare complication of totally implantable subclavian venous access devices

J Surg Oncol. 1996 Jul;62(3):222-5. doi: 10.1002/(SICI)1096-9098(199607)62:3<222::AID-JSO14>3.0.CO;2-8.


Catheter fracture represents a rare problem among non-infectious complications following the insertion of totally implantable long-term central venous access systems for the application of chemotherapeutic agents. A literature survey revealed a total incidence of catheter fractures of 0-2.1%. Imminent catheter fracture can be identified radiologically, using different degrees of catheter narrowing between the clavicle and the first rib, called pinch-off sign. Two cases of catheter fracture are described and potential causes are discussed. Recommendations to avoid the pinch-off sign with the subsequent risk of catheter fracture and migration include a more lateral and direct puncture of the subclavian vein. In case of catheter narrowing in the clavicular-first rib angle, patients should be followed carefully by chest X-rays every 4 weeks. Whenever possible, the system should be removed within 6 months following insertion.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Breast Neoplasms / complications
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / secondary
  • Carcinoma / complications
  • Carcinoma / diagnostic imaging
  • Carcinoma / drug therapy
  • Carcinoma / secondary
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation*
  • Catheters, Indwelling / adverse effects*
  • Equipment Failure
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnostic imaging
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Pharyngeal Neoplasms / complications
  • Pharyngeal Neoplasms / diagnostic imaging
  • Pharyngeal Neoplasms / drug therapy
  • Radiography
  • Subclavian Vein / diagnostic imaging