Spontaneous Catheter Fracture Leading to a Retained Fragment After Central Venous Access Port Removal: Should Preoperative Chest X-rays Be Obtained?

Central venous access ports are used to administer chemotherapy, antibiotics, and total parenteral nutrition, and for frequent blood draws. The device consists of a subcutaneous reservoir (port) and an intravascular piece (catheter). Access is achieved via direct venipuncture of the subclavian, internal jugular, or cephalic vein with the tip at the cavoatrial junction. Retained central venous access ports are relatively uncommon. In most cases, an indwelling time greater than two years can cause an adhesive fibrous sheath to form around the catheter, contributing to more difficult removal. Spontaneous fracture of ports is even less common. Our goal is to discuss spontaneous catheter fracture of a central venous access port leading to a retained fragment in an adult. In this paper, we suggest obtaining a preoperative chest X-ray (CXR) in certain patients prior to central venous access port removal and explain the reasoning behind doing so.