Intravascular treatment for abnormal catheter positioning of port-a-cath system in the subclavian vein: A single-center study

Objective: This study aimed to explore the incidence of abnormal catheter positioning and the effectiveness and safety of intravascular adjustment or removal of abnormally positioned catheters through percutaneous punctures. Materials and methods: A retrospective analysis was conducted on 58 patients with abnormal catheter positioning, treated between January 2009 and June 2019. Intravascular adjustment of the migrated catheters and removal of the fractured catheters were performed through percutaneous puncture using a pigtail catheter, cobra catheter, and gooseneck snare. Results: Of the 58 cases, there were 23 cases of catheter migration and 35 cases of catheter fracture. The incidence of abnormal catheter positioning was 3.0%, corresponding to 1.2% migrations and 1.8% fractures. Among the 23 cases of migration, 1 case did not require adjustment and another underwent unsuccessful adjustment. The rate of successful adjustment of migrated catheters was 91.3%, whereas the rate of successful removal of fractured catheters was 100%. No surgery-related complications were observed either immediately or during the 1-month follow-up period. Conclusions: This study showed that the incidence of abnormal catheter positioning is low. Intravascular techniques used for the adjustment or removal of abnormally placed catheters are safe, efficient, and minimally invasive.