Causes of Fracture at Catheter of Totally Implantable Venous Access Port: A Systematic Review

A totally implantable venous access port (TIVAP) plays a crucial role in the treatment of patients in oncology. Catheter fracture is a serious complication with an estimated incidence of 0, 1% - 1%. The objective of this systematic review is to analyze the mechanism of TIVAP fracture to make physicians aware of this fatal entity. A search of the literature between 1980 and 2019 was conducted using PubMed, Ovid, MEDLINE, and Cochrane Systematic Review databases. The search identified 18 case reports and 8 retrospective studies. Fracture of the middle part of the catheter may be induced by constant compression of the catheter between the first-rib and clavicle, which is called the pinch-off syndrome. Catheter fracture at the port-catheter junction may be caused by extrinsic compression near the port-catheter junction combined with material fatigue due to repeated bending of the catheter with shoulder movement. There is no specific cause for the fracture of a catheter tip. An annual chest X-ray is recommended for the early detection of TIVAP catheter fracture. Percutaneous endovascular retrieval of a dislodged Port-A catheter is both safe and effective.