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Port-a-Cath fracture and migration in paediatric cancer patients: incidence and management at a tertiary care centre – a 15-year experience

Published online by Cambridge University Press:  22 June 2020

Amr Elgehiny Open the ORCID record for Amr Elgehiny [Opens in a new window] ,
Khaled Ghanem ,
Haytham Bou Hussein ,
Mohamed Ahmed ,
Mostafa Abohelwa ,
Mohsen Aboelella ,
Mohamed Mohamed ,
Fadi Bitar Open the ORCID record for Fadi Bitar [Opens in a new window] ,
Miguel Abboud  and
Samir Akel
...Show all authors
Amr Elgehiny
Affiliation:
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Khaled Ghanem
Affiliation:
Children’s Cancer Institute, Beirut, Lebanon
Haytham Bou Hussein
Affiliation:
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mohamed Ahmed
Affiliation:
Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mostafa Abohelwa
Affiliation:
Department of Internal medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mohsen Aboelella
Affiliation:
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mohamed Mohamed
Affiliation:
Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Fadi Bitar
Affiliation:
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Miguel Abboud
Affiliation:
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Samir Akel
Affiliation:
Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
Aghiad Al-Kutoubi
Affiliation:
Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
Ghina Fakhri
Affiliation:
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mariam Arabi*
Affiliation:
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
*
Author for correspondence: Mariam Arabi, MD, Director of In and Outpatient Clinical Services, Head, Fetal Heart Program-Children’s Heart Center, Department of Pediatrics of Adolescent Medicine, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh1107 2020, Beirut, Lebanon. Tel: +961 1 374374x5872/5881/5889; Fax: +961 1 370781. E-mail: [email protected]
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Abstract

Introduction:

Port-a-Cath or chemoport provides prolonged central venous access for cancer patients requiring prolonged chemotherapy. Prolonged use of chemoport is associated with many complications. Dislodgement and migration of chemoport catheter is a rare and reportable complication with potentially serious consequences.

Methods:

The medical charts of 1222 paediatric cancer patients admitted to the Children’s Cancer Center in Lebanon who had chemoports inserted for long-term chemotherapy were retrospectively reviewed. Descriptive analysis of data was conducted.

Results:

Chemoport fracture and migration were found in seven cases with an incidence of 0.57%. The duration of chemoport use before the event of dislodgement varied from 2 months to 102 months. Non-functioning chemoport was the most common presentation. Totally, six cases were managed successfully by loop snaring, three cases by paediatric cardiology team, and three cases by interventional radiology team. One case was managed surgically during chemoport removal.

Conclusion:

Fracture and migration of chemoport catheter is a rare complication of uncertain aetiology and with potentially serious consequences. Percutaneous retrieval, done by experienced cardiologist or interventional radiologist, is the first choice for management of this complication as it is considered as a safe and effective approach.

Keywords

Port-a-Cathchemoportfracturemigrationpaediatricscancer
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 7 , July 2020 , pp. 986 - 990
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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